Department of Endocrinology and Metabolism Disease, Ankara City Hospital, Ankara, Turkey.
Department of Endocrinology and Metabolism Disease, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey.
Int J Clin Pract. 2021 Jul;75(7):e14218. doi: 10.1111/ijcp.14218. Epub 2021 May 9.
It is known that serum thyroglobulin (TG) can increase after fine-needle biopsy of thyroid nodules. We aimed to determine whether TG is increased after ultrasonography (US)-guided fine needle capillary biopsy (FNC) of suspicious cervical lymph nodes (LNs) in thyroidectomised patients and investigate the possible association between change in TG and cytology results.
Data of 188 patients who underwent FNC of suspicious cervical LNs were retrospectively evaluated. Demographical, laboratory and ultrasonography features of LNs were noted. TG levels before FNC (TG ), after FNC (TG ), TG /TG ratio and the number of patients with increased TG were determined. Patients were grouped as benign, nondiagnostic, suspicious for malignancy and malignant according to the cytological results.
TG , TG /TG and rate of patients with increased TG were significantly higher in malignant cytology group than other groups (P < .001). The optimal cut-off level of TG increase that was predictive for malignancy was 7.6% with a sensitivity of 73.7% and specificity of 85.2%. TG increase was not associated with age, sex, Thyroid-stimulating hormone (TSH) level, anti-TG positivity and US features of LNs while significantly lower in patients who received radioactive iodine (RAI) treatment. Among 31 patients with positive anti-TG, TG /TG , and rate of patients with increased TG were higher in malignant compared to benign and nondiagnostic cytology groups.
Serum TG increment and rate of patients with increased TG after FNC of suspicious cervical LNs were higher in patients with malignant cytology than with all other cytology results both in all study group and in sub-group of anti-TG positive patients. Increase in TG after FNC might be an additional tool for determining LN metastasis.
已知甲状腺结节细针穿刺活检后血清甲状腺球蛋白（TG）会升高。我们旨在确定甲状腺切除术后患者经超声引导细针毛细抽吸活检（FNC）检查可疑颈部淋巴结（LNs）后 TG 是否会升高，并探讨 TG 变化与细胞学结果之间的可能关联。
回顾性评估了 188 例行可疑颈部 LNs FNC 的患者的数据。记录了 LNs 的人口统计学、实验室和超声特征。确定了 FNC 前（TG ）、FNC 后（TG ）、TG / TG 比值和 TG 升高患者的数量。根据细胞学结果将患者分为良性、非诊断性、疑似恶性和恶性。
恶性细胞学组的 TG 、TG / TG 和 TG 升高患者比例明显高于其他组（P <.001）。预测恶性的 TG 升高最佳截断值为 7.6%，敏感性为 73.7%，特异性为 85.2%。TG 升高与年龄、性别、促甲状腺激素（TSH）水平、抗 TG 阳性和 LNs 的超声特征无关，而在接受放射性碘（RAI）治疗的患者中明显较低。在 31 例抗 TG 阳性患者中，恶性组的 TG / TG 和 TG 升高患者比例高于良性和非诊断性细胞学组。
与所有其他细胞学结果相比，FNC 检查可疑颈部 LNs 后，恶性细胞学组患者的血清 TG 升高和 TG 升高患者比例更高。FNC 后 TG 的升高可能是确定 LN 转移的另一个工具。
