Clinical Value of Ultrasound-guided FNA and FNA-TG in Identification of Lymph Node Metastasis of Papillary Thyroid Carcinoma

Hailin ZHANG; Mei ZHU; Yang YANG; Lin WEI; Xi CHEN; Bailing WU

doi:10.12259/j.issn.2095-610X.S20221220

Volume 43 Issue 12

Dec. 2022

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2022 > 43(12): 105-110

Hailin ZHANG, Mei ZHU, Yang YANG, Lin WEI, Xi CHEN, Bailing WU. Clinical Value of Ultrasound-guided FNA and FNA-TG in Identification of Lymph Node Metastasis of Papillary Thyroid Carcinoma[J]. Journal of Kunming Medical University, 2022, 43(12): 105-110. doi: 10.12259/j.issn.2095-610X.S20221220

Citation:

Hailin ZHANG, Mei ZHU, Yang YANG, Lin WEI, Xi CHEN, Bailing WU. Clinical Value of Ultrasound-guided FNA and FNA-TG in Identification of Lymph Node Metastasis of Papillary Thyroid Carcinoma[J]. Journal of Kunming Medical University, 2022, 43(12): 105-110. doi: 10.12259/j.issn.2095-610X.S20221220

Citation:

Hailin ZHANG, Mei ZHU, Yang YANG, Lin WEI, Xi CHEN, Bailing WU. Clinical Value of Ultrasound-guided FNA and FNA-TG in Identification of Lymph Node Metastasis of Papillary Thyroid Carcinoma[J]. Journal of Kunming Medical University, 2022, 43(12): 105-110. doi: 10.12259/j.issn.2095-610X.S20221220

PDF( 721 KB)

Clinical Value of Ultrasound-guided FNA and FNA-TG in Identification of Lymph Node Metastasis of Papillary Thyroid Carcinoma

doi: 10.12259/j.issn.2095-610X.S20221220

Hailin ZHANG^{1, 2},
Mei ZHU^{1
,
,},
Yang YANG¹,
Lin WEI¹,
Xi CHEN¹,
Bailing WU¹

1.
Dept. of Ultrasound，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032
2.
Dept. of Ultrasound，The 3rd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650100，China

Received Date: 2022-09-07
Available Online: 2022-12-06
Publish Date: 2022-12-25

Abstract

Abstract

Objective To explore the diagnostic significance of FNA-Tg for lymph nodes with suspected cervical thyroid papillary carcinoma metastasis on the basis of ultrasonic detection and guidance and accurate biopsy of FNA, and establish the threshold of FNA-TG. Methods 74 lymph nodes with suspected metastasis of thyroid cancer were evaluated by fine needle aspiration and analysed pathologically. Lymph nodes were evaluated by comparing FNA alone, FNA-TG value with serum Tg, and drawing ROC to obtain the best diagnostic value of FNA-TG, and the sensitivity, specificity and accuracy of positive results were evaluated. Results There were significant differences in calcification, cortex-medullary boundary, abnormal blood supply and aspect ratio in the diagnosis of cervical lymph node metastasis of papillary thyroid carcinoma （P < 0.05）. The above four indexes had the highest sensitivity in the diagnosis of lymph node metastasis of thyroid cancer. Calcification, multiple hyperecho, cystic changes and elastic imaging had higher hardness specificity, and the accuracy of cortex-medulla boundary and aspect ratio was the highest. The sensitivity, specificity and accuracy of FNA were 75%, 100% and 87.84%. The sensitivity, specificity and accuracy of FNA-Tg/ serum Tg value > 1 were 97.22%, 100% and 98.65%. ROC curve was drawn to obtain the optimal diagnostic threshold of FNA-Tg as 0.575 ng/mL. Conclusion FNA-Tg/ serum Tg > 1, as the diagnostic criteria for lymph node metastasis of papillary thyroid cancer, can better avoid the disadvantages caused by many factors and effectively reduce the error rate, and should be the first choice for the auxiliary diagnosis of lymph node metastasis of papillary thyroid cancer.
- Papillary thyroid carcinoma,
- Biospy,
- Fine-needle,
- Lymphatic metastasis

FullText(HTML)

References(15)

References

[1]	Sherman S I. Thyroid carcinoma[J]. Lancet,2003,36(3):501-511.
[2]	Davies L,Welch H G. Increasing incidence of thyroid cancer in the United States,1973–2002[J]. Am Med Assoc,2006,295(5):2164-2167.
[3]	Chung J,Kim E K,Lim H. Optimal indication of thyroglobulin measurement in fine-needle aspiration for detecting lateral metastatic lymph nodes in patients with papillary thyroid carcinoma[J]. Head Neck,2014,36(6):795-801. doi: 10.1002/hed.23371
[4]	Ahn J E,Lee J H,Yi J S. Diagnostic accuracy of CT and ultrasonography for evaluating metastatic cervical lymph nodes in patients with thyroid cancer[J]. World J Surg,2008,32(7):1552-1558. doi: 10.1007/s00268-008-9588-7
[5]	高明,李小龙,于洋. 甲状腺癌的临床病理及PET-CT的诊断价值[J]. 中华耳鼻咽喉头颈外科杂志,2006,41(6):419-424.
[6]	纪丽丽,姜双全,李守强,等. 穿刺洗脱液甲状腺球蛋白测定在诊断甲状腺乳头状癌转移淋巴结肿的应用[J]. 中华超声影像学杂志,2019,28(4):313-317.
[7]	Pacini F,Fugazzola L,Lippi F,et al. Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses:A clue to the diagnosis of metastatic differentiated thyroid cancer[J]. J Clin Endocrinol Metab,1992,74(6):1401-1404.
[8]	岳林先,马懿,邓立强. 超声检测颈部淋巴结对弥漫性硬化型甲状腺乳头状癌的诊断价值[J]. 中国超声医学杂志,2009,25(10):944-946.
[9]	赵博,王金锐,胡静. 术前超声在分化型甲状腺癌淋巴结手术选择中的临床价值[J]. 中国超声医学杂志,2014,30(11):964-967.
[10]	周建桥,詹维伟. 彩色多普勒超声评估颈部淋巴结疾病血管模式的探讨[J]. 中国医学影像技术,2006,22(7):1031-1034.
[11]	任新平,詹维伟,周萍. 实时超声弹性成像在淋巴结疾病诊断中的应用[J]. 华西医学,2010,25(2):294-297.
[12]	Ghervan C. Thyroid and parathyroid ultrasound[J]. Medical Ultrasonography,2011,13(1):80-84.
[13]	Kessler A,Rappaport Y,Blank A. Cystic appearance of cervical lymph nodes is characteristic of metastatic papillary thyroid carcinoma[J]. J Clin Ultrasound,2003,31(1):21-15. doi: 10.1002/jcu.10130
[14]	Haugen B R,Alexander E K,Bible K C,et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer[J]. Thyroid,2016,26(1):1-133.
[15]	Sohn Y M,Kim M J,Kim E K,et al. Diagnostic performance of thyroglobulin value in indeterminate range in fine needle aspiration washout fluid from lymph nodes of thyroid cancer[J]. Yonsei Med J,2021,53(1):126-131.

Relative Articles(20)

Relative Articles

[1]	Lin WEI, Mei ZHU, Hailin ZHANG, Yuran FENG, Xi CHEN, Bailing WU, Yang YANG. Value of Binary Logit Regression Model Based on FNA-Tg and Serum Tg for Determining Lymph Node Metastasis or Recurrence of Thyroid Cancer. Journal of Kunming Medical University, 2023, 44(2): 102-107. doi: 10.12259/j.issn.2095-610X.S20230219
[2]	Ran ZHANG, Jie YANG, Enzi FENG, Xiaofeng YUAN, Qing WANG. Correlation between Gene Mutation and Invasiveness in Papillary Thyroid Carcinoma. Journal of Kunming Medical University, 2023, 44(2): 125-132. doi: 10.12259/j.issn.2095-610X.S20230223
[3]	Shizhou LI, Xiaoguang HE, Yan LIN, Yuxiao LI, Xi YANG, Xiaoyu WANG, Shenghao YANG. Clinical Analysis of Cervical Lymph Node Metastatic Squamous Cell Carcinoma of Unknown Primary Site. Journal of Kunming Medical University, 2022, 43(7): 80-85. doi: 10.12259/j.issn.2095-610X.S20220710
[4]	Shifeng XIONG, Hao ZOU. Analysis of Risk Factors for Lymph Node Metastasis of Gallbladder Cancer. Journal of Kunming Medical University, 2022, 43(3): 55-59. doi: 10.12259/j.issn.2095-610X.S20220318
[5]	Wen ZHAO, Tengfei KE, Xingyue HU, Renjie ZHAO. Value of Dual-energy CT Spectrum Curve from Primary Tumor in Prediction of Central Occult Lymph Node Metastasis in Papillary Thyroid Cancer. Journal of Kunming Medical University, 2022, 43(10): 74-78. doi: 10.12259/j.issn.2095-610X.S20221028
[6]	Jianfei LU, Rui BU, Xiaoyan LIU, Xing ZHANG, Yu DING, Ran ZHANG. Efficacy of Conventional Ultrasound and Contrast-enhanced Ultrasound in Preoperative Diagnosis of Lateral Cervical Lymph Node Metastasis from Papillary Thyroid Carcinoma. Journal of Kunming Medical University, 2022, 43(12): 75-80. doi: 10.12259/j.issn.2095-610X.S20221214
[7]	Lin WEI, Yu-ran FENG, Hui YUAN, Ke-yu ZHOU, Yi ZHAO, Jun QIAN, Mei ZHU. Comparison of Six Methods of Ultrasound-guided Fine-needle Aspiration Biopsy of Thyroid Nodules. Journal of Kunming Medical University, 2021, 42(10): 92-98. doi: 10.12259/j.issn.2095-610X.S20211044
[8]	Ya CAO, Hui ZHANG, Lin MENG, Huan-ran NI, Yi ZHAO, Guang-yan WANG, Zhi-ying LIU, Xiao-mei YANG, Li-chun YANG. Value of Color Doppler Ultrasonography, Fine Needle Aspiration Cytology, and the Level of Thyroglobulin in the Diagnosis of Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma. Journal of Kunming Medical University, 2021, 42(11): 105-110. doi: 10.12259/j.issn.2095-610X.S20211119
[9]	Ren Yan Xin , Liao Man Ge , Yang Jie , Wang Xiao Li , Li Xiao Jiang . . Journal of Kunming Medical University, 2020, 41(07): 43-48.
[10]	Hua Jie , Ruan Ling Yu , Ma Ding Qian , Zuo Xiao Shuang , Xiang Run Qing , Fang Shan Dan , Fan Yuan . Thyroid Papillary Carcinoma Cells TPC-1 Apoptosis Induced by Ursolic Acid. Journal of Kunming Medical University, 2018, 39(01): 10-15.
[11]	Li Lei , Yang Jie , Wang Wei Lin , Wang Hu . The Correlation between the Location of Thyroid Papillary Microcarcinoma and Cervical Lymph Node Metastasis. Journal of Kunming Medical University, 2018, 39(06): 91-95.
[12]	Yu Tao . The Accuracy of Imaging and Pathological Diagnosis in 110 Cases of Pulmonary Space-occuping Lesions. Journal of Kunming Medical University,
[13]	Gao Chun Lin . . Journal of Kunming Medical University,
[14]	Zhou JieYan . . Journal of Kunming Medical University,
[15]	Yang Hong Jun . . Journal of Kunming Medical University,
[16]	Sun Rui Mei . . Journal of Kunming Medical University,
[17]	Chen Fu Fei . . Journal of Kunming Medical University,
[18]	Dang Yong . . Journal of Kunming Medical University,
[19]	Ma Hai Feng . . Journal of Kunming Medical University,
[20]	Liu Hui Jin . . Journal of Kunming Medical University,