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中华普外科手术学杂志(电子版) ›› 2023, Vol. 17 ›› Issue (06) : 701 -704. doi: 10.3877/cma.j.issn.1674-3946.2023.06.030

综述

洗脱液甲状腺球蛋白在甲状腺乳头状癌转移淋巴结中的应用
徐成, 王璐璐, 王少华()   
  1. 210004 南京,南京医科大学附属妇产医院(南京市妇幼保健院)普通外科
  • 收稿日期:2023-07-29 出版日期:2023-12-26
  • 通信作者: 王少华

Application of eluent thyroglobulin in metastatic lymph nodes of thyroid papillary carcinoma

Cheng Xu, Lulu Wang, Shaohua Wang()   

  1. Department of General Surgery, Women’s Hospital of Nanjing Medical University, Nanjing Maternity Hospital and Child Health Care Hospital, Nanjing 210004, China
  • Received:2023-07-29 Published:2023-12-26
  • Corresponding author: Shaohua Wang
  • About author:

    Xu Cheng and Wang Lulu are co-first authors

引用本文:

徐成, 王璐璐, 王少华. 洗脱液甲状腺球蛋白在甲状腺乳头状癌转移淋巴结中的应用[J/OL]. 中华普外科手术学杂志(电子版), 2023, 17(06): 701-704.

Cheng Xu, Lulu Wang, Shaohua Wang. Application of eluent thyroglobulin in metastatic lymph nodes of thyroid papillary carcinoma[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 701-704.

在甲状腺乳头状癌(PTC)颈部淋巴结(CLN)转移的诊断中,细针穿刺洗脱液甲状腺球蛋白(FNA-Tg)的临床应用获得广泛关注。对于体积较小或囊性变的颈部淋巴结,FNA-Tg诊断颈部转移淋巴结的价值高于超声(US)和细针穿刺细胞学(FNAC)检查。另外,FNA-Tg联合FNAC诊断颈部淋巴结转移的敏感性和特异性接近100%。然而,由于研究中样本差异、检测方法以及试剂盒多样等原因,转移性颈部淋巴结的FNA-Tg的诊断阈值尚未标准化,目前已报道的诊断阈值多在0.2~77 ng/ml之间。FNA-Tg检测的准确性主要受血清抗甲状腺球蛋白抗体水平、血清甲状腺球蛋白水平、甲状腺是否切除以及颈部淋巴结特征等因素影响。本文综述了近年来FNA-Tg在PTC颈淋巴结转移诊断中的应用及研究,为临床PTC颈部淋巴结转移的诊断提供可靠依据。

In the diagnosis of cervical lymph node (CLN) metastasis of papillary thyroid carcinoma (PTC), fine needle aspiration eluent thyroglobulin (FNA-Tg) has received extensive attention. For small or cystic cervical lymph nodes, FNA-Tg is more valuable than ultrasound (US) and fine needle aspiration cytology (FNAC) in the diagnosis of cervical metastatic lymph nodes. In addition, the sensitivity and specificity of FNA-Tg combined with FNAC in the diagnosis of cervical lymph node metastasis were close to 100%. However, due to sample differences, various detection methods and kits in studies, the diagnostic threshold of FNA-Tg in metastatic cervical lymph nodes has not been standardized, and most of the reported diagnostic thresholds range from 0.2 to 77 ng/ml. The accuracy of FNA-Tg detection was mainly affected by the level of serum anti-thyroglobulin antibody, serum thyroglobulin level, whether the thyroid was resected or not, and the characteristics of cervical lymph nodes. This article reviews the application and research of FNA-Tg in the diagnosis of cervical lymph node metastasis of PTC in recent years, which provides a reliable basis for the diagnosis of cervical lymph node metastasis of PTC.

[1]
Miller KDFidler-Benaoudia MKeegan TH,et al. Cancer statistics for adolescents and young adults,2020[J]. CA Cancer J Clin, 2020, 70(6): 443-459.
[2]
中华医学会内分泌学分会,中华医学会外科学分会甲状腺及代谢外科学组,中国抗癌协会头颈肿瘤专业委员会,等. 甲状腺结节和分化型甲状腺癌诊治指南(第二版)[J]. 中华内分泌代谢杂志, 2023, 39(03): 181-226.
[3]
Jiang HJWu CWChiang FY,et al. Reliable sonoimagedata features for nodal thyroglobulin to diagnose recurrent lymph node metastasis from papillary thyroid carcinoma[J]. Clin Otolaryngol, 2018, 43(4): 1065-1072.
[4]
杜峻峰,安然,李世拥. 分化型甲状腺癌术中纳米碳示踪对颈淋巴结清扫的指导意义[J/CD]. 中华普外科手术学杂志(电子版), 2018, 12(06): 462-465.
[5]
Hasukic BJakubovic-Cickusic ASehanovic E,et al. Fine Needle Aspiration Cytology and Thyroglobulin Antibodies in Preoperative Diagnosis of Thyroid Malignancy[J]. Med Arch, 2019, 73(6): 382-385.
[6]
Wang YDuan YLi H,et al. Detection of thyroglobulin in fine-needle aspiration for diagnosis of metastatic lateral cervical lymph nodes in papillary thyroid carcinoma: A retrospective study[J]. Front Oncol, 2022, 12: 909723.
[7]
Jiang HJHsiao PJ. Clinical application of the ultrasound-guided fine needle aspiration for thyroglobulin measurement to diagnose lymph node metastasis from differentiated thyroid carcinoma-literature review[J]. Kaohsiung J Med Sci, 2020, 36(4): 236-243.
[8]
Abi-Raad RPrasad MBaldassari R,et al. The Value of Negative Diagnosis in Thyroid Fine-Needle Aspiration: a Retrospective Study with Histologic Follow-Up[J]. Endocr Pathol, 2018, 29(3): 269-275.
[9]
Haugen BRAlexander EKBible KC,et al. 2015American 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): 1-133.
[10]
Leenhardt LErdogan MFHegedus L,et al. 2013European thyroid association guidelines for cervical ultrasound scan and ultrasound-guided techniques in the postoperative management of patients with thyroid cancer[J]. Eur Thyroid J, 2013, 2(3): 147-159.
[11]
Zhu XHZhou JNQian YY,et al. Diagnostic values of thyroglobulin in lymph node fine-needle aspiration washout: a systematic review and meta-analysis diagnostic values of FNA-Tg[J]. Endocr J, 2020, 67(2): 113-123.
[12]
Jeon MJKim WGJang EK,et al. Thyroglobulin level in fine-needle aspirates for preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid carcinoma: two different cutoff values according to serum thyroglobulin level[J]. Thyroid, 2015, 25(4): 410-416.
[13]
Duval MZanella ABCristo AP,et al. Impact of Serum TSH and Anti-Thyroglobulin Antibody Levels on Lymph Node Fine-Needle Aspiration Thyroglobulin Measurements in Differentiated Thyroid Cancer Patients[J]. Eur Thyroid J, 2017, 6(6): 292-297.
[14]
Khadra HMohamed HAl-Qurayshi Z,et al. Superior detection of metastatic cystic lymphadenopathy in patients with papillary thyroid cancer by utilization of thyroglobulin washout[J]. Head Neck, 2019, 41(1): 225-229.
[15]
孙辉,李世杰,付言涛,等. 分化型甲状腺癌功能性或传统性颈淋巴结清扫的利弊[J/CD]. 中华普外科手术学杂志(电子版), 2018, 12(06): 455-457.
[16]
Sun JLi PChen X,et al. The influence of thyroid status,serum Tg,TSH,and TgAb on FNA-Tg in cervical metastatic lymph nodes of papillary thyroid carcinoma[J]. Laryngoscope Investig Otolaryngol, 2022, 7(1): 274-282.
[26]
Lee JPark HLJeong CW,et al. CYFRA 21-1in Lymph Node Fine Needle Aspiration Washout Improves Diagnostic Accuracy for Metastatic Lymph Nodes of Differentiated Thyroid Cancer[J]. Cancers(Basel), 2019, 11(4): 487-501.
[27]
Pak KSuh SHong H,et al. Diagnostic values of thyroglobulin measurement in fine-needle aspiration of lymph nodes in patients with thyroid cancer[J]. Endocrine, 2015, 49(1): 70-77.
[28]
Wang JJiang XXiao G,et al. Excellent diagnostic performance of FNA-Tg in detecting lymph nodes metastases from papillary thyroid cancer[J]. Future Oncol, 2020, 16(33): 2735-2746.
[29]
Hong CMJeong JHSon SH,et al. Serum thyroglobulin elevation after needle aspiration of the lymph nodes: the predictive value for detecting metastasis in papillary thyroid cancer patients - a pilot study[J]. Medicine(Baltimore), 2019, 98(31): e16461.
[30]
Lee JHLee HCYi HW,et al. Influence of thyroid gland status on the thyroglobulin cutoff level in washout fluid from cervical lymph nodes of patients with recurrent/metastatic papillary thyroid cancer[J]. Head Neck, 2016, 38Suppl 1: E1705-E1712.
[31]
Jo KKim MHLim Y,et al. Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody[J]. Eur J Endocrinol, 2015, 173(4): 489-497.
[32]
Konca Degertekin CYalcin MMCerit T,et al. Lymph node fine-needle aspiration washout thyroglobulin in papillary thyroid cancer: Diagnostic value and the effect of thyroglobulin antibodies[J]. Endocr Res, 2016, 41(4): 281-289.
[33]
Jia XWang YLiu Y,et al. Thyroglobulin Measurement Through Fine-Needle Aspiration for Optimizing Neck Node Dissection in Papillary Thyroid Cancer[J]. Ann Surg Oncol, 2022, 29(1): 88-96.
[34]
Wang YZhao HWang YX,et al. Improvement in the Detection of Cystic Metastatic Papillary Thyroid Carcinoma by Measurement of Thyroglobulin in Aspirated Fluid[J]. Biomed Res Int, 2016, 2016: 8905916.
[35]
Kahramangil BKose EDonmez M,et al. Thyroglobulin washout from cervical lymph node fine needle aspiration biopsies in patients with differentiated thyroid cancer: an analysis of different expressions to use in post-total thyroidectomy follow-up[J]. Surgery, 2020, 167(1): 34-39.
[17]
Zhao HWang YWang MJ,et al. Influence of presence/absence of thyroid gland on the cutoff value for thyroglobulin in lymph-node aspiration to detect metastatic papillary thyroid carcinoma[J]. BMC Cancer, 2017, 17(1): 296-303.
[18]
Xu YWu DWu W,et al. Diagnostic value of cytology,thyroglobulin,and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer: A systematic review and network meta-analysis[J]. Medicine(Baltimore), 2019, 98(45): e17859.
[19]
Wu XLiu YLi K,et al. Predictive Value of FNA-Tg and TgAb in Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma[J]. Technol Cancer Res Treat, 2022, 21: 1-9.
[20]
Bournaud CCharrié ANozières C,et al. Thyroglobulin measurement in fine-needle aspirates of lymph nodes in patients with differentiated thyroid cancer: a simple definition of the threshold value,with emphasis on potential pitfalls of the method[J]. Clin Chem Lab Med, 2010, 48(8): 1171-1177.
[21]
Xia SChen YZhan W,et al. Ultrasound-Guided Fine-Needle Aspiration Versus Fine-Needle Capillary Sampling in Evaluation of Lymph Node Metastasis of Thyroid Cancer[J]. Front Oncol, 2021, 11: 642142.
[22]
Snozek CLChambers EPReading CC,et al. Serum thyroglobulin,high-resolution ultrasound,and lymph node thyroglobulin in diagnosis of differentiated thyroid carcinoma nodal metastases[J]. J Clin Endocrinol Metab, 2007, 92(11): 4278-4281.
[23]
Piotrkowski-Viale FReyes ADios A,et al. Effects of sample storage and diluents in the reliability of thyroglobulin measurement in the washout of fine needle aspirates[J]. Endocrine, 2017, 56(3): 504-508.
[24]
Borel ALBoizel RFaure P,et al. Significance of low levels of thyroglobulin in fine needle aspirates from cervical lymph nodes of patients with a history of differentiated thyroid cancer[J]. Eur J Endocrinol, 2008, 158(5): 691-698.
[25]
Torres MRNóbrega Neto SHRosas RJ,et al. Thyroglobulin in the washout fluid of lymph-node biopsy: what is its role in the follow-up of differentiated thyroid carcinoma?[J]. Thyroid, 2014, 24(1): 7-18.
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