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| Diagnostic Value of Fine Needle Aspiration Cytology Combined with Eluate Thyroglobulin Test for Thyroid Cancer Neck Lymph Node Metastasis |
| CHAI Jixin, QI Yantao, WANG Jingjing, et al |
| The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China |
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Abstract Objective: To explore the diagnostic value of fine needle aspiration cytology combined with eluate thyroglobulin test for thyroid cancer neck lymph node metastasis. Methods: A total of 90 patients with suspected thyroid cancer who were treated in our hospital from April 2016 to June 2019 were selected and divided into group A, group B and joint group according to different detection methods. Patients in group A underwent fine needle biopsy, patients in group B underwent eluent thyroglobulin assay, and patients in the joint group underwent both tests. The gold standard for diagnosis was the pathological findings after surgery. The diagnosis results of patients with different diagnosis methods were compared. Results: Group A patients had 5 lymph node samples from zone II, 13 from zone III and 12 from zone IV. Postoperative pathological findings: 27 positive, 3 negative Group B patients had 3 lymph node samples from zone II, 14 from zone III, and 13 from zone IV, with postoperative pathological findings: 25 positive and 5 negative. The joint group patients had 4 lymph node samples from zone II, 12 from zone III, and 14 from zone IV. The postoperative pathological findings were 28 positive cases and 2 negative cases. The specificity and yoden index of the joint group were significantly higher than those of group A and group B (P<0.05), the negative predictive value and sensitivity of group A were significantly lower than those of group B and the joint group (P<0.05), and the positive predictive value of the joint group was significantly higher than that of group B (P<0.05), with no significant difference from group A (P>0.05). According to the test results of group B and the joint group, FNA-Tg concentration was (171.45 ± 42.33) μg/L in 51 patients with positive PTC, and (20.63 ± 11.57) μg/L in 9 patients with negative PTC. The ROC curve was plotted with FNA-Tg concentration as the classification standard (lower area 0.972 ± 0.020, P=0.000, 95%CI=0.932~1.000), and the diagnostic cut-off value was 98.5μg /L, with a sensitivity of 86.27% and specificity of 100.00%. Using the pathology test as the standard, the Kappa value of the test in group A = 0.103 and the Kappa value of the test in group B = 0.280, the consistency between the two groups and the pathology test standard was poor (P>0.05); the consistency between the joint group and the pathology test results was high (P<0.05) and the consistency was average (Kappa value = 0.634) Conclusion: FNAC combined with FNA-Tg is consistent with pathological diagnosis, and the combination of the two methods can complement each other, which is of certain value for the diagnosis of lymph node metastasis in TC patients.
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2022, Vol. 28 
