Lymph Node Metastases of Medullary Thyroid Cancer: Role of Calcitonin in the Washout Fluid of Fine-Needle Aspiration

Autor:	Nuno Cunha, Fernando Rodrigues, Ana Paula Moniz, Bernardo Marques, Frederico Valido, Raquel Martins, Teresa Martins, Jacinta Santos, Olga Ilheu, Joana Couto, Ana Rita Elvas
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Thyroid nodules Article Subject Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Diseases of the endocrine glands. Clinical endocrinology 03 medical and health sciences 0302 clinical medicine Endocrinology Interquartile range Cytology Medicine skin and connective tissue diseases Lymph node neoplasms medicine.diagnostic_test Endocrine and Autonomic Systems business.industry Washout Medullary thyroid cancer RC648-665 medicine.disease body regions medicine.anatomical_structure Fine-needle aspiration surgical procedures operative Calcitonin 030220 oncology & carcinogenesis business Nuclear medicine Research Article
Zdroj:	International Journal of Endocrinology International Journal of Endocrinology, Vol 2020 (2020)
ISSN:	1687-8337
DOI:	10.1155/2020/9267972
Popis:	Introduction. The diagnostic value of calcitonin (CT) measurement in fine-needle aspirate washout (FNA-CT) for medullary thyroid cancer (MTC) lymph node (LN) metastases remains to be determined. It may increase the diagnostic sensitivity, but data on this subject is sparse. Objective. Our study aimed to evaluate the utility of FNA-CT in the diagnosis of LN metastases of MTC. Methods. We retrospectively investigated, in our institutional database, 69 consecutive FNA LN cytology from 42 patients who underwent FNA cytology and CT measurement in needle washout for suspicious LN between 2012 and 2017. Results. From the total of 69 FNA, 30 (43.4%) were performed in patients with personal history of MTC. MTC was detected in 19 FNA cytology (27.5%), and CT was detectable in needle washout in 23 cases (median = 2014 pg/mL; interquartile range = 490–15111 pg/mL). Based on the combined results of FNA-CT and FNA cytology, LN surgical resection was performed in 33 cases (47.8%). Histology reported MTC LN metastases in 21 lesions (63.6%). Regarding the diagnosis of MTC LN metastases, FNA cytology showed sensitivity of 81.8% and specificity of 97.9%, and FNA-CT demonstrated sensitivity of 100% and specificity of 97.9%. We determined through ROC analysis an optimal FNA-CT cut-off value of 23 pg/mL for the diagnosis of LN metastases (sensitivity 100%; specificity 100%). Conclusions. FNA-CT may be a valuable diagnostic tool for detection of MTC LN metastases, along with FNA cytology, and it should be included in the clinical workup of neck adenopathies in patients with MTC or with thyroid nodules.
Databáze:	OpenAIRE
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