The purpose of this study was to evaluate optimal indication of thyroglobulin (Tg) measurement in fine-needle aspiration (FNA) for detecting lateral metastatic lymph nodes in patients with papillary thyroid carcinoma (PTC).Methods.
We performed a retrospective study of 241 lymph nodes of 220 patients who underwent ultrasound-guided FNA with Tg in FNA (FNA-Tg) washout fluid measurements for suspicious lymph nodes.Results.
On multivariate analysis, hyperechogenicity, cystic change, presence of calcifications, and peripheral vascularity were independent factors predictive of lymph node metastasis. After adding FNA-Tg, sensitivity and accuracy were significantly increased when the lymph node had 1 or 2 suspicious ultrasound features. However, sensitivity and accuracy were not significantly increased when the lymph node had multiple suspicious ultrasound features.Conclusion.
Additional FNA-Tg can help diagnose a metastatic lymph node with 1 or 2 suspicious ultrasound features. However, additional FNA-Tg is not beneficial in lymph nodes with highly suspicious ultrasound features, in which FNA alone is sufficient for diagnosis of predictive of lymph node. © 2013 Wiley Periodicals, Inc. Head Neck 36: 795–801, 2014