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Thyroglobulin in the Washout Fluid of Lymph-Node Biopsy: What Is Its Role in the Follow-Up of Differentiated Thyroid Carcinoma?

2013; Mary Ann Liebert, Inc.; Volume: 24; Issue: 1 Linguagem: Inglês

10.1089/thy.2013.0244

1557-9077

Maria Roseneide dos Santos Torres, Sebastião Horácio Nóbrega Neto, Rosalina Jenner Rosas, Aline Lemos Barros Martins, André Luis Correia Ramos, Thomaz Cruz,

Head and Neck Anomalies

Background: The clinical evaluation of enlarged local lymph nodes (LNs) is difficult at the beginning and throughout the follow-up of differentiated thyroid carcinoma (DTC). Although the examination of samples collected from LNs by fine-needle aspiration biopsy cytology (FNAB-C) is extremely specific for the diagnosis of metastases, its sensitivity is low, especially in paucicellular samples. Summary: The measurement of thyroglobulin (Tg) in the fine-needle aspiration biopsy (FNAB) washout fluid (FNAB-Tg) increases the diagnostic performance of cytology to up to 100% sensitivity and specificity. However, the application of FNAB-Tg is currently hindered by the absence of methodological standardization, a lack of definite cutoff points, and the ongoing debate regarding its accuracy in nonthyroidectomized patients, those with elevated serum Tg, and those with circulating anti-Tg antibodies. Conclusion: FNAB-Tg improves the diagnostic performance of FNAB-C in LN metastases, even when the latter is unable to diagnose the metastases. For that reason, FNAB-Tg should be included in the monitoring of DTC.