Zanella André B, Meyer Erika L Souza, Balzan Letícia, Silva Antônio C, Camargo Joíza, Migliavacca Alceu, Guimarães José Ricardo, Maia Ana Luiza
Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, RS, Brazil.
Arq Bras Endocrinol Metabol. 2010 Aug;54(6):550-4. doi: 10.1590/s0004-27302010000600007.
The aim of this study was to evaluate the accuracy of the measurement of thyroglobulin in washout needle aspiration biopsy (FNAB-Tg) to detect papillary thyroid cancer (PTC) metastases.
Forty-three patients (51.4 ± 14.6 years) with PTC diagnosis and evidence of enlarged cervical lymph nodes (LN) were included. An ultrasound-guided fine-needle aspiration of suspicious LN was performed, for both cytological examination and measurement of FNAB-Tg.
The median values of FNAB-Tg in patients with metastatic LN (n = 5) was 3,419 ng/mL (11.1-25,538), while patients without LN metastasis (n = 38) showed levels of 3.7 ng/mL (0.8-7.4). Considering a 10 ng/mL cutoff value for FNAB-Tg, the sensitivity and specificity was 100%. There were no differences on the median of FNAB-Tg measurements between those on (TSH 0.07 mUI/mL) or off levothyroxine (TSH 97.4 mUI/mL) therapy (3.3 vs. 3.8 ng/mL, respectively; P = 0.2).
The results show that evaluation of FNAB-Tg in cervical LN is a valuable diagnostic tool for PTC metastases that can be used independent of the thyroid status.
本研究旨在评估洗脱针吸活检（FNAB-Tg）中甲状腺球蛋白测量对于检测甲状腺乳头状癌（PTC）转移灶的准确性。
纳入43例确诊为PTC且有颈部淋巴结（LN）肿大证据的患者（年龄51.4±14.6岁）。对可疑LN进行超声引导下细针穿刺抽吸，用于细胞学检查和FNAB-Tg测量。
有LN转移的患者（n = 5）中，FNAB-Tg的中位数为3419 ng/mL（11.1 - 25538），而无LN转移的患者（n = 38）的水平为3.7 ng/mL（0.8 - 7.4）。以FNAB-Tg的截断值10 ng/mL计算，敏感性和特异性均为100%。接受左甲状腺素治疗（TSH 0.07 mUI/mL）和未接受治疗（TSH 97.4 mUI/mL）的患者，FNAB-Tg测量中位数无差异（分别为3.3 ng/mL和3.8 ng/mL；P = 0.2）。
结果表明，评估颈部LN中的FNAB-Tg是诊断PTC转移灶的一种有价值的工具，其使用可独立于甲状腺状态。
