The significance for thyroglobulin detection in suspicious cervical lymph node fine-needle aspirate washout fluid after surgery in papillary thyroid carcinoma patients

doi:10.3969/j.issn.1673-8640.2015.03.006

Abstract

Abstract: Objective

To determine the change of thyroglobulin(Tg) in fine-needle aspirate(FNA)of cervical lymph node(CLN) in order to provide the reference of papillary thyroid carcinoma(PTC) metastasis identification in lymph node Under ultrasound-guided FNA, 109 samples from patients that were suspicious for metastatic PTC were collected, and 16 samples from patients whose cervical lymph nodes diagnosed as reactive were used as control group. FNA-Tg levels were measured by immunochemiluminescence assay. Then, the relationships between FNA-Tg levels and metastatic PTC were investigated. The positive detection rates of FNA-Tg test and traditional cytology test were compared. The macrophage cell and tumor cell in FNA slides were counted, then divided them into 4 groups.The rank sum test was used to analyze the differences of FNA-Tg levels from samples of different cellular components.

Results

Among the 109 samples, 84 samples had positive FNA-Tg results which were consistent with their pathological results(metastatic PTC). The detect rates of traditional cytology test in simple metastatic PTC and cystic metastatic PTC were 93.9% and 88.6%, respectively. However, the detection rates of FNA-Tg test were 100% in both simple and cystic metastatic PTC. After group clavsification, according to their cellular components, is showed that FNA-Tg levels were not associated with the number of tumor cells. FNA-Tg levels of the group with cystic macrophage were significantly higher than those of the group with no macrophage(U=367.00,P<0.01).

Conclusions

Tg test by FNA washout fluid can be used as a valuable marker of lymph node metastasls from PTC. FNA-Tg test could improve the deteetiom sensitivity in diagnosing metastatic PTC especially in cystic metastasis. Macrophages seen in traditional cytology test could be indicative of metastasis.

Key words: Thyroglobulin, Fine-needle washout fluid, Papillary thyroid carcinoma, Lymph node metastasis

CLC Number:

R446.1

MAO Minjing, YE Tingjun, SHI Xinming, PENG Yibing, WANG Xuefeng. The significance for thyroglobulin detection in suspicious cervical lymph node fine-needle aspirate washout fluid after surgery in papillary thyroid carcinoma patients[J]. Laboratory Medicine, 2015, 30(3): 230-233.

Figures/Tables 4

References 13

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FNAC	例数	FNA-Tg	病理结果
阴性	25	阴性	—(超声随访)
阳性	77	阳性	PTC转移
不能确定^*	3	阳性	PTC转移
不能确定^#	4	阳性	PTC转移
反应性淋巴结	16	阴性	反应性淋巴结

FNAC	例数	FNA-Tg	病理结果
阴性	25	阴性	—(超声随访)
阳性	77	阳性	PTC转移
不能确定^*	3	阳性	PTC转移
不能确定^#	4	阳性	PTC转移
反应性淋巴结	16	阴性	反应性淋巴结

病理结果	例数	FNAC	FNA-Tg法
单纯PTC转移	49	46(93.9)	49(100)
PTC转移伴囊性变	35	31(88.6)	35(100)
合计	84	77(91.7)	84(100)

病理结果	例数	FNAC	FNA-Tg法
单纯PTC转移	49	46(93.9)	49(100)
PTC转移伴囊性变	35	31(88.6)	35(100)
合计	84	77(91.7)	84(100)

分组	例数	肿瘤细胞个数	吞噬细胞	Tg (ng/mL)
A组	49			3 004(380~8 895)
A1组	19	≤500	未见	2 684(300~8 900)
A2组	30	>500	未见	3 205(396~9 118)
B组	35			11 030(4 800~13 200)^*
B1组	22	≤500	可见	10 515(5 528~13 900)
B2组	13	>500	可见	11 200(4 030~13 200)