Diagnostic Algorithm for Metastatic Lymph Nodes of Differentiated Thyroid Carcinoma

Cancers

卷:13

TaeYong Kim¹  DongEun Song²  YoungJun Choi³  JungHwan Baek³  SaeRom Chung³  JeongHyun Lee³  Tae-Yon Sung⁴ 

[1] Department of Endocrinology and Metabolism, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea;

[2] Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea;

[3] Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea;

[4] Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea;

关键词: papillary thyroid carcinoma;    neoplasm metastasis;    ultrasonography;    biopsy;    fine-needle;    thyroglobulin;   

DOI  :  10.3390/cancers13061338

来源: DOAJ

【 摘 要 】

We aimed to evaluate appropriate strategies for interpreting fine-needle aspiration cytology (FNAC) and thyroglobulin concentrations obtained through aspiration (FNA-Tg) results based on the sonographic features of lymph nodes (LNs). Consecutive patients who underwent ultrasound-guided FNAC and FNA-Tg for metastatic LNs from differentiated thyroid carcinomas (DTCs) from January 2014 to December 2018 were reviewed retrospectively. LNs were categorized sonographically as suspicious, indeterminate, or benign. The optimal FNA-Tg cutoff for metastatic LNs was evaluated preoperatively, after lobectomy, and after total thyroidectomy. The diagnostic performances of FNA-Tg, FNAC, and their combination were analyzed based on the sonographic features of LNs. The malignancy rates of LNs were analyzed based on the sonographic features, FNAC, and FNA-Tg results. Of the 1543 LNs analyzed, 528 were benign, whereas 1015 were malignant. FNA-Tg increased the sensitivity and accuracy of FNAC for LNs. The malignancy rate of LNs found to be malignant by FNAC or elevated FNA-Tg ranged from 82% to 100%, regardless of the sonographic features. The malignancy rate of LNs with indeterminate or benign FNAC findings and low FNA-Tg were stratified according to their sonographic features. We propose a diagnostic algorithm, based on combined FNAC, FNA-Tg, and ultrasound features of LNs, for diagnosing metastatic LNs of DTCs.

【 授权许可】

Unknown