细针穿刺洗脱液甲状腺球蛋白测定诊断分化型甲状腺癌淋巴结转移

齐淑轶; 邓莅霏; 谢梅; 朱雪清; 王一凤; 刘学明

doi:10.13201/j.issn.1001-1781.2018.19.009

细针穿刺洗脱液甲状腺球蛋白测定诊断分化型甲状腺癌淋巴结转移

- 1. 江西省肿瘤医院病理科(南昌, 330029);
- 2. 江西省肿瘤医院头颈外科
基金项目:
江西省科技厅社发项目 (No:20142BBG70079)

江西省卫生厅科技计划项目 (No:20141122)

详细信息

通讯作者: 邓莅霏, E-mail:denglifei@126.com

中图分类号: R736.1

收稿日期: 2018-08-10

Thyroglobulin measurement in fine-needle aspiration washout fluid for detection of differentiated thyroid cancer lymph nodes metastases

- 1 Department of Pathology, Jiangxi Provincal Cancer Hospital, Nanchang, 330029, China;
- 2 Department of Head and Neck Surgery, Jiangxi Provincal Cancer Hospital

More Information

Corresponding author: DENG Lifei, E-mail: denglifei@126.com

Received Date: 10 August 2018

摘要

摘要: 目的: 通过检测细针穿刺洗脱液中甲状腺球蛋白水平诊断分化型甲状腺癌颈淋巴结转移的可行性。方法: 47例接受手术治疗的分化型甲状腺癌患者,术中对手术切除的颈淋巴结直视下细针穿刺并进行病理学诊断,同时对抽吸物的洗脱液进行甲状腺球蛋白的测定,将检测结果与病理结果进行对照。预先设定FNA-Tg/serunTg>1、10 ng/ml、100 ng/ml 3个阳性界值,分别计算其诊断的敏感性及特异性并进行对比。结果: 46枚转移性淋巴结中甲状腺球蛋白浓度的中位值为5 251 ng/ml(1.79~408 300 ng/ml),11枚阴性淋巴结中甲状腺球蛋白浓度的中位值为0.68 ng/ml(0.04~125.4 ng/ml),3个阳性界值的诊断敏感性分别为91.30%、97.83%、93.48%,诊断的特异性分别为81.82%、63.64%、90.90%,诊断的准确性分别为89.47%、91.22%、92.98%。结论: 淋巴结细针穿刺洗脱液中甲状腺球蛋白测定诊断分化型甲状腺癌淋巴结转移具有可行性。
- 甲状腺肿瘤 /
- 甲状腺球蛋白 /
- 细针穿刺 /
- 淋巴结转移
Abstract: Objective: To investigate the feasibiity of detecting lymph node metastasis in differentiated thyroid cancer patients by thyroglobin (Tg) measurement in fine-needle aspiration washout fluid.Method: Forty-seven differentiated thyroid cancer patients with cervical lymph node metastasis were included in this study. Fine-needle aspirations were performed on lymph nodes which were surgically resected for measurement of Tg in washout fluid. Diagnostic sensitivity, specificity and accuracy were evaluated according to three predetermined Tg threshold values:FNA-Tg/serum Tg>1, 10 ng/ml and 100 ng/ml.Result: The meadian value of FNA-Tg in metastatic lymph node (n=46) was 5 177 ng/ml (1.79-408 300 ng/ml),while lymph node without metastasis (n=11) showed a meadian level of 0.63 ng/ml (0.04-125.4 ng/ml). With the threshold of FNA-Tg level at FNA-Tg/serum Tg>1, 10 ng/ml and 100 ng/ml respectively, the diagnostic sensitivity was 91.3%, 97.83% and 93.48% respectively, the specificity was 81.82%, 63.64% and 90.90% respectively, and the accuracy was 89.47%, 91.22% and 92.98% respectively.Conclusion: Thyroglobin measurement in fine-needle aspiration washout fluid is effective to diagnose lymph node metastasis in differentiated thyroid cancer.
- thyroid neoplasm /
- thyroglobin /
- fine-needle aspiration /
- lymph node metastasis

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参考文献(14)

[1]	KIM M J, KIM E K, KIM B M, et al.Thyroglobulin measurement in fine-needle aspirate washouts:the criteria for neck node dissection for patients with thyroid cancer[J].Clin Endocrinol (Oxf), 2009, 70:145-151.
[2]	张晶晶, 张庆丰, 佘翠萍, 等.临床T1N0M0甲状腺乳头状癌是否行中央区颈部淋巴结清扫的研究[J].临床耳鼻咽喉头颈外科杂志, 2017, 31 (9):708-710.
[3]	陶久梅, 王艳, 朱姝, 等.甲状腺乳头状癌颈部淋巴结转移规律及影响因素分析[J].临床耳鼻咽喉头颈外科杂志, 2014, 28 (12):859-861, 864.
[4]	LEENHARDT L, ERDOGAN M F, HEGEDUS L, et al.2013 European thyroid association guidelines for cervical ultrasound scan and ultrasoundguided techniques in the postoperative management of patients withthyroid cancer[J].Eur Thyroid J, 2013, 2:147-159.
[5]	HAUGEN B R, ALEXANDER E K, BIBLE K C, et al.2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer:The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer[J].Thyroid, 2016, 26:1-133.
[6]	张浩, 张学东, 程丽萍, 等.甲状腺癌淋巴结转移组织中FNAB-TG测定与FNAB细胞学检查的对比研究[J].中华肿瘤防治杂志, 2010, 17 (8):613-614.
[7]	BOI F, BAGHINO G, ATZENI F, et al.The diagnostic value for differentiated thyroid carcinoma metastases of thyroglobulin (Tg) measurement in washout fluid from fine-needle aspiration biopsy of neck lymph nodes is maintained in the presence of circulating antiTg antibodies[J].J Clin Endocrinol Metab, 2006, 91:1364-1369.
[8]	AL-HILLI Z, STRAJINA V, MCKENZIE T J, et al.Thyroglobulin measurement in fine-needle aspiration improves the diagnosis of cervical lymph node metastases in papillary thyroid carcinoma[J].Ann Surg Oncol, 2017, 24:739-744.
[9]	PACINI F, FUGAZZOLA L, LIPPI F, et al.Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses:a clue to the diagnosis of metastatic differentiated thyroid cancer[J].J Clin Endocrinol Metab, 1992, 74:1401-1404.
[10]	GRANI G, FUMAROLA A.Thyroglobulin in lymph node fine-needle aspiration washout:a systematic review and meta-analysis of diagnostic accuracy[J].J Clin Endocrinol Metab, 2014, 99:1970-1982.
[11]	CUNHA N, RODRIGUES F, CURADO F, et al.Thyroglobulin detection in fine-needle aspirates of cervical lymph nodes:a technique for the diagnosis of metastatic differentiated thyroid cancer[J].Eur J Endocrinol, 2007, 157:101-107.
[12]	URUNO T, MIYAUCHI A, SHIMIZU K, et al.Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer[J].World J Surg, 2005, 29:483-485.
[13]	KANNAN S, CHAUHAN S, NAVEEN, et al.Estimation of thyroglobulin in lymph node aspirates:Pilot experience from a tertiary referral cancer center[J].Indian J Endocrinol Metab, 2016, 20:359-363.
[14]	GIOVANELLA L, BONGIOVANNI M, TRIMBOLI P.Diagnostic value of thyroglobulin assay in cervical lymph node fine-needle aspirations for metastatic differentiated thyroid cancer[J].Curr Opin Oncol, 2013, 25:6-13.