Journal of Diagnostics Concepts & Practice >

2023 , Vol. 22 >Issue 03: 255 - 260

DOI: https://doi.org/10.16150/j.1671-2870.2023.03.08

Original articles

Analysis of ultrasonographic features of thyroid lymph nodes associated with positive thyroglobulin in fine needle aspiration eluent of metastatic lymph nodes

Expand
  • 1. Department of Ultrasound, Ruijin Hospital/Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
    2. Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025,China

Received date: 2022-02-08

  Online published: 2023-11-17

Fold

Abstract

Objective: To explore the ultrasonographic characteristics of lymph nodes associated with positive fine-needle aspiration thyroglobulin (FNA-Tg) in eluent for suspected metastatic lymph nodes of papillary thyroid carcinoma (PTC). Methods: A total of 87 patients with PTC who were treated between January 2019 and December 2021 were selected, with 109 suspected metastatic lymph nodes examined by fine needle aspiration cytology and detected for FNA-Tg. Those with FNA-Tg/serum Tg>1 was defined as metastastic lymph nodes, and with FNA-Tg/serum Tg≤1 was defined as non-metastastic lymph nodes. All suspicious lymph nodes had ultrasonographic signs of suspicious metastasis, including local hyperechogenicity, cystic change, absence of hilum, microcalcification, solbiati index <2, and marginal blood supply. Univariate and multivariate logistic regression were applied to analyze the correlation of these suspicious lymph node ultrasound signs with positive FNA-Tg. Results: Among 109 suspected metastatic lymph nodes, 30 lymph nodes were FNA-Tg negative and 79 were FNA-Tg positive. Among the ultrasonographic features of suspected metastatic lymph nodes, local hyperecho and cystic change were independent risk factors for positive FNA-Tg detection(P<0.05). Conclusions: For suspected metastatic lymph nodes with local hyperecho and cystic changes in conventional ultrasound, FNA-Tg determination can be performed along with fine needle aspiration cytology examination to improve the detection rate of PTC metastatic lymph nodes,providing more accurate diagnostic information for the clinic.

Key words： Lymphnodes; Thyroglobulin; Sonographic features

Cite this article

KUANG Lijun, TAO Lingling, ZHAN Weiwei, LI Weiwei, FAN Jinfang, ZHOU Wei . Analysis of ultrasonographic features of thyroid lymph nodes associated with positive thyroglobulin in fine needle aspiration eluent of metastatic lymph nodes[J]. Journal of Diagnostics Concepts & Practice, 2023 , 22(03) : 255 -260 . DOI: 10.16150/j.1671-2870.2023.03.08

References

[1] LIU Z, ZENG W, LIU C, et al. Diagnostic accuracy of ultrasonographic features for lymph node metastasis in pa-pillary thyroid microcarcinoma: a single-center retrospective study[J]. World J Surg Oncol, 2017, 15(1):32.
[2] HONG Y R, LEE S H, LIM D J, et al. The stratification of patient risk depending on the size and ratio of metastatic lymph nodes in papillary thyroid carcinoma[J]. World J Surg Oncol, 2017, 15(1):74.
[3] 漆芹伶, 李素平, 杨凡慧, 等. 二甲双胍在甲状腺癌治疗中的研究现状与进展[J]. 安徽医学, 2021, 42(10):1186-1188.
[3] QI Q L, LI S P, YANG F H, et al. Research status and progress of metformin in the treatment of thyroid cancer[J]. An Hui Med, 2021, 42(10):1186-1188.
[4] 李勇, 郭敏, 康英英. MicroRNA在甲状腺癌中的研究进展[J]. 中华全科医学, 2022, 20(2):298-301,351.
[4] LI Y, GUO M, KANG Y Y. Research progress of microRNA in thyroid cancer[J]. Chin General Prac, 2022, 20(2):298-301,351.
[5] ZHAO H, LI H. Meta-analysis of ultrasound for cervical lymph nodes in papillary thyroid cancer: Diagnosis of central and lateral compartment nodal metastases[J]. Eur J Radiol, 2019, 112:14-21.
[6] XU Y, WU D, WU W, et al. Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer: A systematic review and network meta-analysis[J]. Medicine (Baltimore), 2019, 98(45):e17859.
[7] LEE J, PARK H L, JEONG C W, et al. CYFRA 21-1 in Lymph Node Fine Needle Aspiration Washout Improves Diagnostic Accuracy for Metastatic Lymph Nodes of Differentiated Thyroid Cancer[J]. Cancers(Basel), 2019, 11(4):487.
[8] AL-HILLI Z, STRAJINA V, MCKENZIE T J, et al. Thyroglobulin Measurement in Fine-Needle Aspiration Improves the Diagnosis of Cervical Lymph Node Metastases in Papillary Thyroid Carcinoma[J]. Ann Surg Oncol, 2017, 24(3):739-744.
[9] 周伟, 陈易来, 詹维伟. 细针穿刺洗脱液中甲状腺球蛋白检测在诊断分化型甲状腺癌淋巴结转移中的应用进展[J]. 诊断学理论与实践, 2020, 19(4):339-343.
[9] ZHOU W, CHEN Y L, ZHAN W W. Advances in application of detection of thyroglobulin in washout in fluid of fine needle aspiration biopsy for diagnosing lymph node metastasis of differentiated thyroid carcinoma[J]. J Diagn Concepts Pract, 2020, 19(04):339-343.
[10] 丁珂, 崔秋丽, 严昆, 等. 超声对甲状腺乳头状癌颈部中央区淋巴结转移的诊断价值及漏诊原因分析[J]. 中国超声医学杂志, 2018, 34(9):782-785.
[10] DING K, CUI Q L, YAN K, et al. The Diagnostic Value and Cause of Missed Diagnosis of Ultrasound in Predicting Cervical Central Lymph Node Metastasis of Papillary Thyroid Cancer[J]. Chin J Ultrasound Med, 2018, 34(9):782-785.
[11] LIU C, ZHANG L, LIU Y, et al. Ultrasonography for the Prediction of High-Volume Lymph Node Metastases in Papillary Thyroid Carcinoma: Should Surgeons Believe Ultrasound Results?[J]. World J Surg, 2020, 44(12):4142-4148.
[12] LEE J H, LEE H C, YI H W, et al. Influence of thyroid gland status on the thyroglobulin cutoff level in washout fluid from cervical lymph nodes of patients with recurrent/metastatic papillary thyroid cancer[J]. Head Neck, 2016, 38(Suppl 1):E1705-E1712.
[13] HAUGEN B R, ALEXANDER E K, BIBLE K C, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Diffe-rentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer[J]. Thyroid, 2016, 26(1):1-133.
[14] 杜晶. ACR、Kwak与中国TI-RADS超声诊断分类标准在甲状腺结节风险评估中的应用解读[J]. 肿瘤, 2021, 41(11):733-739.
[14] DU J. Interpretations and applications of ultrasound diagnostic classification systems of ACR TI-RADS, Kwak TI-RADS and Chinese-TI-RADS in the risk assessments of thyroid nodules[J]. Tumor, 2021, 41(11):733-739.
[15] 尹新璐, 陈博婕, 莫嘉寅, 等. 喉前淋巴结转移在甲状腺乳头状癌中的临床意义[J]. 肿瘤, 2021, 41(11):749-757.
[15] YIN X L, CHEN B J, MO J Y, et al. Clinical significance in Delphian lymph node metastasis in papillary thyroid carcinoma[J]. Tumor, 2021, 41(11):749-757.
[16] 张婷婷, 魏文俊, 王宇. 低危型甲状腺癌诊疗争议[J]. 重庆医科大学学报, 2022, 47(11):1265-1267.
[16] ZHANG T T, WEI W J, WANG Y. Controversies in the management of low-risk thyroid carcinoma[J]. J Chong-qing Med Univ, 2022, 47(11):1265-1267.
[17] 况李君, 陶玲玲, 詹维伟, 等. 负压细针抽吸和毛细抽吸活检法穿刺洗脱液中甲状腺球蛋白测定在甲状腺乳头状癌淋巴结转移中的诊断价值比较[J]. 诊断学理论与践, 2021, 20(4):367-371.
[17] KUANG L J, TAO L L, ZHAN W W, et al. Comparison of the diagnostic value of thyroglobulin measurement in needle washouts by FNAC and by FNCC for detecting node metastases in thyroid papillary carcinoma[J]. J Diagn Concepts Pract, 2021, 20(4):367-371.
[18] PIGAL A, DRAGANOVA-TACHEVA R, SOLOMIDES C C, et al. Thyroglobulin wash testing in the surveillance of patients with thyroid carcinoma: proposal for a reflex test[J]. Acta Cytol, 2013, 57(6):545-549.
[19] JIANG H J, WU C W, CHIANG F Y, et al. Reliable sonographic features for nodal thyroglobulin to diagnose recurrent lymph node metastasis from papillary thyroid carcinoma[J]. Clin Otolaryngol, 2018, 43(4):1065-1072.
[15] KESSLER A, RAPPAPORT Y, BLANK A, et al. Cystic appearance of cervical lymph nodes is characteristic of metastatic papillary thyroid carcinoma[J]. J Clin Ultrasound, 2003, 31(1):21-25.
[20] SOHN Y M, KWAK J Y, KIM E K, et al. Diagnostic approach for evaluation of lymph node metastasis from thyroid cancer using ultrasound and fine-needle aspiration biopsy[J]. AJR Am J Roentgenol, 2010, 194(1):38-43.
[21] KHADRA H, MOHAMED H, AL-QURAYSHI Z, et al. Superior detection of metastatic cystic lymphadenopathy in patients with papillary thyroid cancer by utilization of thyroglobulin washout[J]. Head Neck, 2019, 41(1):225-229.
[22] TAHVILDARI A M, PAN L, KONG C S, et al. Sonographic-Pathologic Correlation for Punctate Echogenic Reflectors in Papillary Thyroid Carcinoma: What Are They?[J]. J Ultrasound Med, 2016, 35(8):1645-1652.
[23] LIU Z, ZENG W, LIU C, et al. Diagnostic accuracy of ultrasonographic features for lymph node metastasis in pa-pillary thyroid microcarcinoma: a single-center retrospective study[J]. World J Surg Oncol, 2017, 15(1):32.
Options
Outlines

/

〈 〉