| Autor: |
Mikosiński P; Department of General and Oncological Surgery, University Hospital and Education Centre, Medical University of Lodz, ul. Pomorska 251, 92-231 Lodz, Poland., Wołowiec-Korecka E; Institute of Materials Science and Engineering, Faculty of Mechanical Engineering, Lodz University of Technology, B. Stefanowskiego 1/15, 90-537 Lodz, Poland., Pomorski L; Department of General and Oncological Surgery, Maria Sklodowska-Curie Memorial District Hospital, ul. Parzeczewska 35, 95-100 Zgierz, Poland., Mikosińska A; Faculty of Medicine, Medical University of Lodz, al. T. Kosciuszki 4, 90-419 Lodz, Poland., Kaczka K; Department of General and Oncological Surgery, University Hospital and Education Centre, Medical University of Lodz, ul. Pomorska 251, 92-231 Lodz, Poland., Mikosiński S; Department of Nuclear Medicine and Oncological Endocrinology, Maria Sklodowska-Curie Memorial District Hospital, ul. Parzeczewska 35, 95-100 Zgierz, Poland. |
| Abstrakt: |
The aim of this study was to establish the cut-off value for the thyroglobulin (Tg) concentration in washout fluid from fine needle aspiration biopsy (FNA-Tg) in the detection of cervical lymph node metastases of differentiated thyroid cancer (DTC). We evaluated the validity and clinical utility of fine needle aspiration biopsy cytology (FNAB-C), FNA-Tg, and the combined method in detecting DTC recurrences. The study included 82 patients after the total thyroidectomy and elective and, in some cases, also selective cervical lymphadenectomy. The majority of patients also underwent subsequent 131 I ablative therapy. The patients presented with 1-6 enlarged and/or ultrasonographically suspicious cervical lymph nodes. One to four aspirates of each lymph node were taken, with a total of 297 samples. An FNA-Tg of 4.34 ng/mL was established as the cut-off value for detecting cervical lymph node DTC metastases for the IRMA Brahms DYNO test, Tg-S. FNAB-C is highly specific (91-99%) but not sensitive enough (53-69%) to be used as a standalone method in the detection of cervical lymph node metastases. FNA-Tg is more sensitive (91%), but caution should be taken when selecting patients for surgery with an FNA-Tg higher than the established cut-off value but lower than the serum Tg concentration. To select patients for lymphadenectomy, we recommend using the combined method (FNAB-C and FNA-Tg) with a sensitivity of 96% and specificity of up to 97%. More than one sample should be taken with each fine needle aspiration biopsy (FNAB) to obtain a representative set of samples. |
