Diagnostic Value Of Thyroglobulin Measurements With Fine-needle Aspiration Biopsy For Lymph Node Metastases In Patients With A History Of Differentiated Thyroid Cancer

Objectives:To investigate the diagnostic significance of ultrasound,FNA and FNA-Tg in the metastatic lymph nodes of suspected cervical thyroid carcinoma.And through the FNA-Tg measurement,discussing the best diagnosis of differentiated thyroid carcinoma cervical lymph node metastases and provide accurate basis for the determination of patients with cervical lymph nodes.Methods:Randomly screening of patients with thyroid nodules and differentiated thyroid cancer,a total of 74 lymph nodes,using ultrasound to examine the cervical lymph nodes.FNA and FNA-Tg for suspicious enlarged lymph nodes were performed.Postoperative pathologic results were taken as the gold standard.To evaluate the random 65 lymph nodes FNA-Tg/serum Tg,the optimal threshold value for diagnosis of FNA-Tg ROC curve,and FNA efficiency on diagnosing of Lateral neck node metastasis.The diagnostic results were verified by the other 9 lymph nodes.Results:Differentiated thyroid carcinoma diagnosis of neck lymph node metastasis,calcification,boundary,cortex and medulla,abnormal blood supply,aspect ratio,the four indicators in the diagnosis of thyroid cancer lymph node metastasis of the highest sensitivity.flake hyperechoic,calcification,cystic change and elasticity imaging specific degree of hardness are with higher specificity,boundary between cortex and medulla,and aspect ratio of the highest accuracy.FNA for suspicious metastatic lymph nodes sensitivity,specificity,accuracy were 77.42%,100%,89.23%.Considering FNA-Tg/serum Tg>1 as a threshold value for FNA-Tg,the sensitivity,specificity,accuracy were 96.77%,100%,98.46%,respectively;Results The best diagnostic threshold of FNA-Tg for suspicious metastatic lymph nodes obtained by ROC curve of FNA-Tg was 0.93ng/m;FNA verified by the other 9 lymph nodes,The results showed that the sensitivity,specificity and accuracy were 60%,100%,77.78%;FNA-Tg/serum Tg>1 verified by the other 9 lymph nodes,The results showed that the sensitivity,specificity and accuracy of FNA-Tg/serum Tg>1 were 100%.The sensitivity,specificity and accuracy of FNA-Tg>0.93ng/ml were 80%,75%,77.78%respectively.Conclusions:The ultrasound plays an important role in the evaluation of cervical lymph node metastasis of thyroid carcinoma..FNATg/securm Tg>1 should be selected as the criterion for the positive value.