Cut-off value for needle washout thyroglobulin in athyrotropic patients

Young Hen Lee, Hyung Suk Seo, Sang-Il Suh, Nam-Joon Lee, Jung Hyuk Kim, Hae Young Seol, Ju-Han Lee, Soon Young Kwon, Nan Hee Kim, Ji A Seo, Kyung Sook Yang

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives/Hypothesis: The purpose of this study was to determine the appropriate cut-off value for fine needle aspiration-thyroglobulin (FNA-Tg) associated with postoperative recurrences and validate the diagnostic efficacy of FNA-Tg in patients after total thyroidectomy compared with concomitant cytology (C). Study Design: Retrospective. Methods: We retrospectively evaluated the results of ultrasound-guided FNAs performed for suspicious cervical lesions of 40 patients (male:female = 10:30; mean age, 44.0 years) after total thyroidectomy (mean duration, 89.1 months), to acquire the material for Tg and C analysis. After collection of the cytologic sample, we rinsed the same needle with 1 mL of normal saline for Tg radioimmunoassay. Results: Of 40 lesions (mean size, 0.89 cm; range, 0.3-3.5cm), 21 were confirmed as recurrences and 19 were nonrecurrences. The rates of nondiagnostic sampling and sensitivity and specificity of FNA-C when diagnostic sampling was obtained were 40% (16/40), 100% (14/14), and 90.0% (9/10), respectively. According to receiver operating characteristic analysis, the optimal cut-off value of FNA-Tg was 4.1 ng/mL (sensitivity, 100% [21/21]; specificity, 100% [19/19], P < .05). Furthermore, in 16 inconclusive lesions due to nondiagnostic cytologic results, the FNA-Tg results coincided with a final diagnosis (seven recurrences and nine nonrecurrences). The cases with maximum diameters <1 cm showed a significantly increased rate of nondiagnostic cytologic results, and the FNA-Tg results were more helpful than lesions ≥1 cm in diagnosing a recurrence (P < .05). Conclusions: Measurement of FNA-Tg is helpful for distinguishing recurrent from nonrecurrent lesions in the majority of patients who were previously treated for well-differentiated papillary thyroid carcinoma.

Original languageEnglish
Pages (from-to)1120-1124
Number of pages5
JournalLaryngoscope
Volume120
Issue number6
DOIs
Publication statusPublished - 2009 Jun 1

Fingerprint

Thyroglobulin
Fine Needle Biopsy
Needles
Recurrence
Thyroidectomy
ROC Curve
Radioimmunoassay
Cell Biology
Retrospective Studies
Sensitivity and Specificity

Keywords

  • Cervical recurrence
  • Sonography
  • Thyroglobulin
  • Thyroid cancer

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Cut-off value for needle washout thyroglobulin in athyrotropic patients. / Lee, Young Hen; Seo, Hyung Suk; Suh, Sang-Il; Lee, Nam-Joon; Kim, Jung Hyuk; Seol, Hae Young; Lee, Ju-Han; Kwon, Soon Young; Kim, Nan Hee; Seo, Ji A; Yang, Kyung Sook.

In: Laryngoscope, Vol. 120, No. 6, 01.06.2009, p. 1120-1124.

Research output: Contribution to journalArticle

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abstract = "Objectives/Hypothesis: The purpose of this study was to determine the appropriate cut-off value for fine needle aspiration-thyroglobulin (FNA-Tg) associated with postoperative recurrences and validate the diagnostic efficacy of FNA-Tg in patients after total thyroidectomy compared with concomitant cytology (C). Study Design: Retrospective. Methods: We retrospectively evaluated the results of ultrasound-guided FNAs performed for suspicious cervical lesions of 40 patients (male:female = 10:30; mean age, 44.0 years) after total thyroidectomy (mean duration, 89.1 months), to acquire the material for Tg and C analysis. After collection of the cytologic sample, we rinsed the same needle with 1 mL of normal saline for Tg radioimmunoassay. Results: Of 40 lesions (mean size, 0.89 cm; range, 0.3-3.5cm), 21 were confirmed as recurrences and 19 were nonrecurrences. The rates of nondiagnostic sampling and sensitivity and specificity of FNA-C when diagnostic sampling was obtained were 40{\%} (16/40), 100{\%} (14/14), and 90.0{\%} (9/10), respectively. According to receiver operating characteristic analysis, the optimal cut-off value of FNA-Tg was 4.1 ng/mL (sensitivity, 100{\%} [21/21]; specificity, 100{\%} [19/19], P < .05). Furthermore, in 16 inconclusive lesions due to nondiagnostic cytologic results, the FNA-Tg results coincided with a final diagnosis (seven recurrences and nine nonrecurrences). The cases with maximum diameters <1 cm showed a significantly increased rate of nondiagnostic cytologic results, and the FNA-Tg results were more helpful than lesions ≥1 cm in diagnosing a recurrence (P < .05). Conclusions: Measurement of FNA-Tg is helpful for distinguishing recurrent from nonrecurrent lesions in the majority of patients who were previously treated for well-differentiated papillary thyroid carcinoma.",
keywords = "Cervical recurrence, Sonography, Thyroglobulin, Thyroid cancer",
author = "Lee, {Young Hen} and Seo, {Hyung Suk} and Sang-Il Suh and Nam-Joon Lee and Kim, {Jung Hyuk} and Seol, {Hae Young} and Ju-Han Lee and Kwon, {Soon Young} and Kim, {Nan Hee} and Seo, {Ji A} and Yang, {Kyung Sook}",
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AU - Lee, Young Hen

AU - Seo, Hyung Suk

AU - Suh, Sang-Il

AU - Lee, Nam-Joon

AU - Kim, Jung Hyuk

AU - Seol, Hae Young

AU - Lee, Ju-Han

AU - Kwon, Soon Young

AU - Kim, Nan Hee

AU - Seo, Ji A

AU - Yang, Kyung Sook

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N2 - Objectives/Hypothesis: The purpose of this study was to determine the appropriate cut-off value for fine needle aspiration-thyroglobulin (FNA-Tg) associated with postoperative recurrences and validate the diagnostic efficacy of FNA-Tg in patients after total thyroidectomy compared with concomitant cytology (C). Study Design: Retrospective. Methods: We retrospectively evaluated the results of ultrasound-guided FNAs performed for suspicious cervical lesions of 40 patients (male:female = 10:30; mean age, 44.0 years) after total thyroidectomy (mean duration, 89.1 months), to acquire the material for Tg and C analysis. After collection of the cytologic sample, we rinsed the same needle with 1 mL of normal saline for Tg radioimmunoassay. Results: Of 40 lesions (mean size, 0.89 cm; range, 0.3-3.5cm), 21 were confirmed as recurrences and 19 were nonrecurrences. The rates of nondiagnostic sampling and sensitivity and specificity of FNA-C when diagnostic sampling was obtained were 40% (16/40), 100% (14/14), and 90.0% (9/10), respectively. According to receiver operating characteristic analysis, the optimal cut-off value of FNA-Tg was 4.1 ng/mL (sensitivity, 100% [21/21]; specificity, 100% [19/19], P < .05). Furthermore, in 16 inconclusive lesions due to nondiagnostic cytologic results, the FNA-Tg results coincided with a final diagnosis (seven recurrences and nine nonrecurrences). The cases with maximum diameters <1 cm showed a significantly increased rate of nondiagnostic cytologic results, and the FNA-Tg results were more helpful than lesions ≥1 cm in diagnosing a recurrence (P < .05). Conclusions: Measurement of FNA-Tg is helpful for distinguishing recurrent from nonrecurrent lesions in the majority of patients who were previously treated for well-differentiated papillary thyroid carcinoma.

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KW - Thyroglobulin

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