Comparison of the diagnostic performances of US-guided fine needle aspiration cytology and thyroglobulin measurement for lymph node metastases in patients with differentiated thyroid carcinoma: a meta-analysis.

Szczegóły
Abstrakt

Tytuł:: Comparison of the diagnostic performances of US-guided fine needle aspiration cytology and thyroglobulin measurement for lymph node metastases in patients with differentiated thyroid carcinoma: a meta-analysis.
Autorzy:: Liu RB; Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China.; Guangdong Provincial Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Zhou DL; Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China.
Xu BH; Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China.
Yang XH; Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China.
Liu Q; Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China.
Zhang X; Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China.
Tang T; Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China.
Ye ZL; Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China. .
Li Y; Department of Molecular Diagnostics, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China. .
Źródło:: European radiology [Eur Radiol] 2021 May; Vol. 31 (5), pp. 2903-2914. Date of Electronic Publication: 2020 Oct 30.
Typ publikacji:: Journal Article; Meta-Analysis
Język:: English
Imprint Name(s):: Original Publication: Berlin : Springer International, c1991-
MeSH Terms:: Thyroglobulin*
Thyroid Neoplasms*/diagnostic imaging
Biopsy, Fine-Needle ; Humans ; Lymph Nodes/diagnostic imaging ; Lymphatic Metastasis ; Sensitivity and Specificity ; Ultrasonography
References:: Marotta V, Malandrino P, Russo M et al (2020) Fathoming the link between anthropogenic chemical contamination and thyroid cancer. Crit Rev Oncol Hematol 150:102950. (PMID: 10.1016/j.critrevonc.2020.102950)
Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA Cancer J Clin 69:7–34. (PMID: 10.3322/caac.21551)
Lee J, Song Y, Soh EY (2014) Prognostic significance of the number of metastatic lymph nodes to stratify the risk of recurrence. World J Surg 38:858–862. (PMID: 10.1007/s00268-013-2345-6)
Schlumberger MJ (1998) Papillary and follicular thyroid carcinoma. N Engl J Med 338:297–306. (PMID: 10.1056/NEJM199801293380506)
Wang LY, Palmer FL, Nixon IJ et al (2015) Lateral neck lymph node characteristics prognostic of outcome in patients with clinically evident N1b papillary thyroid cancer. Ann Surg Oncol 22:3530–3536. (PMID: 10.1245/s10434-015-4398-2)
Haugen BR, Alexander EK, Bible KC et al (2016) 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. Thyroid 26:1–133. (PMID: 10.1089/thy.2015.0020)
Jiang HJ, Hsiao PJ (2020) Clinical application of the ultrasound-guided fine needle aspiration for thyroglobulin measurement to diagnose lymph node metastasis from differentiated thyroid carcinoma-literature review. Kaohsiung J Med Sci 36:236-243.
Sohn YM, Kim MJ, Kim EK, Kwak JY (2012) Diagnostic performance of thyroglobulin value in indeterminate range in fine needle aspiration washout fluid from lymph nodes of thyroid cancer. Yonsei Med J 53:126–131. (PMID: 10.3349/ymj.2012.53.1.126)
Salmaslioglu A, Erbil Y, Citlak G et al (2011) Diagnostic value of thyroglobulin measurement in fine-needle aspiration biopsy for detecting metastatic lymph nodes in patients with papillary thyroid carcinoma. Langenbecks Arch Surg 396:77–81. (PMID: 10.1007/s00423-010-0723-1)
Kim M, Jeon MJ, Kim WG et al (2016) Comparison of thyroglobulin measurements using three different immunoassay kits: a BRAMHS Tg-Plus RIA kit, a BRAMHS hTg sensitive Kryptor kit, and a Beckman Coulter ACCESS immunoassay kit. Endocrinol Metab (Seoul) 31:462–468. (PMID: 10.3803/EnM.2016.31.3.462)
Cho YY, Chun S, Lee SY, Chung JH, Park HD, Kim SW (2016) Performance evaluation of the serum thyroglobulin assays with immunochemiluminometric assay and immunoradiometric assay for differentiated thyroid cancer. Ann Lab Med 36:413–419. (PMID: 10.3343/alm.2016.36.5.413)
Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PMM (2003) The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol 56:1129–1135. (PMID: 10.1016/S0895-4356(03)00177-X)
Beynon R, Leeflang MM, McDonald S, et al (2013) Search strategies to identify diagnostic accuracy studies in MEDLINE and EMBASE. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.MR000022.pub3.
Penny F, Whiting P, Anne WS et al (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529–536. (PMID: 10.7326/0003-4819-155-8-201110180-00009)
Bolboacă S, Jäntschi L (2005) Binomial distribution sample confidence interval estimation for positive and negative likelihood ratio medical key parameters. AMIA Annu Symp Proc 2005:66–70.
Al-Hilli Z, Strajina V, McKenzie TJ et al (2017) Thyroglobulin measurement in fine-needle aspiration improves the diagnosis of cervical lymph node metastases in papillary thyroid carcinoma. Ann Surg Oncol 24:739–744. (PMID: 10.1245/s10434-016-5625-1)
Bournaud C, Charrie A, Nozieres C et al (2010) 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. Clin Chem Lab Med 48:1171–1177. (PMID: 10.1515/CCLM.2010.220)
Cunha N, Rodrigues F, Curado F et al (2007) Thyroglobulin detection in fine-needle aspirates of cervical lymph nodes: a technique for the diagnosis of metastatic differentiated thyroid cancer. Eur J Endocrinol 157:101–107. (PMID: 10.1530/EJE-07-0088)
Holmes BJ, Sokoll LJ, Li QK (2014) Measurement of fine-needle aspiration thyroglobulin levels increases the detection of metastatic papillary thyroid carcinoma in cystic neck lesions. Cancer Cytopathol 122:521–526. (PMID: 10.1002/cncy.21413)
Jeon SJ, Kim E, Park JS et al (2009) Diagnostic benefit of thyroglobulin measurement in fine-needle aspiration for diagnosing metastatic cervical lymph nodes from papillary thyroid cancer: correlations with US features. Korean J Radiol 10:106–111. (PMID: 10.3348/kjr.2009.10.2.106)
Jo K, Kim MH, Lim Y et al (2015) Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody. Eur J Endocrinol 173:489–497. (PMID: 10.1530/EJE-15-0344)
Jung JY, Shin JH, Han BK, Ko EY (2013) Optimized cutoff value and indication for washout thyroglobulin level according to ultrasound findings in patients with well-differentiated thyroid cancer. AJNR Am J Neuroradiol 34:2349–2353. (PMID: 10.3174/ajnr.A3687)
Kim MJ, Kim EK, Kim BM et al (2009) Thyroglobulin measurement in fine-needle aspirate washouts: the criteria for neck node dissection for patients with thyroid cancer. Clin Endocrinol (Oxf) 70:145–151. (PMID: 10.1111/j.1365-2265.2008.03297.x)
Lee YH, Seo HS, Suh SI et al (2010) Cut-off value for needle washout thyroglobulin in athyrotropic patients. Laryngoscope 120:1120–1124. (PMID: 10.1002/lary.20893)
Giovanella L, Ceriani L, Suriano S (2011) Lymph node thyroglobulin measurement in diagnosis of neck metastases of differentiated thyroid carcinoma. J Thyroid Res 2011:621839. (PMID: 10.4061/2011/621839)
Moon JH, Kim YI, Lim JA et al (2013) Thyroglobulin in washout fluid from lymph node fine-needle aspiration biopsy in papillary thyroid cancer: large-scale validation of the cutoff value to determine malignancy and evaluation of discrepant results. J Clin Endocrinol Metab 98:1061–1068. (PMID: 10.1210/jc.2012-3291)
Shi JH, Xu YY, Pan QZ, Sui GQ, Zhou JP, Wang H (2015) The value of combined application of ultrasound-guided fine needle aspiration cytology and thyroglobulin measurement for the diagnosis of cervical lymph node metastases from thyroid cancer. Pak J Med Sci 31:1152–1155. (PMID: 10.12669/pjms.315.6726)
Shin HJ, Lee HS, Kim EK, Moon HJ, Lee JH, Kwak JY (2015) A study on serum antithyroglobulin antibodies interference in thyroglobulin measurement in fine-needle aspiration for diagnosing lymph node metastasis in postoperative patients. PLoS One 10:e0131096. (PMID: 10.1371/journal.pone.0131096)
Sigstad E, Heilo A, Paus E et al (2007) The usefulness of detecting thyroglobulin in fine-needle aspirates from patients with neck lesions using a sensitive thyroglobulin assay. Diagn Cytopathol 35:761–767. (PMID: 10.1002/dc.20726)
Tang S, Buck A, Jones C, Sara Jiang X (2016) The utility of thyroglobulin washout studies in predicting cervical lymph node metastases: one academic medical center’s experience. Diagn Cytopathol 44:964–968. (PMID: 10.1002/dc.23554)
Yap NS, Maher R, Learoyd DL (2014) Any detectable thyroglobulin in lymph node biopsy washouts suggests local recurrence in differentiated thyroid cancer. Endocr Connect 3:150–155. (PMID: 10.1530/EC-14-0071)
Zhang HS, Wang RJ, Fu QF et al (2014) Diagnostic value of thyroglobulin measurement with fine-needle aspiration biopsy for lymph node metastases in patients with a history of differentiated thyroid cancer. Asian Pac J Cancer Prev 15:10905–10909. (PMID: 10.7314/APJCP.2014.15.24.10905)
Li Q, Zhao BW, Lv JH et al (2016) Diagnostic value of fine-needle aspiration and thyroglobulin measurement in fine-needle aspiration for node metastasis in thyroid carcinoma before thyroidectomy. Chin J Ultrasound Med 32:400–403.
Wu Y, Yu XQ, Hu HY, Zhu GX, Guo SH, Du FY (2018) Value of fine needle aspiration cytology combined with fine needle aspiration thyroglobulin measurements in evaluation of metastatic lymph nodes in patients with papillary thyroid carcinoma. J Clin Ultrasound in Med 20:615–628.
Xu YY (2014) The value of joint application of ultrasonic imaging guided fine needle aspiration and thyroglobulin determination in diagnosis of postoperative lymph node metastasis of papillary thyroid cancer. Master Degree Thesis, Jilin University, Changchun, China.
Zhou L, Zhang G, Zhang DQ et al (2017) Application and evaluation of fine needle aspiration biopsy and eluate detection for cervical lymph node dissection decision in patients with thyroid carcinoma. Chin J Pract Surg 37:1002–1006.
Wang LY, Ganly I (2016) Nodal metastases in thyroid cancer: prognostic implications and management. Future Oncol 12:981–994. (PMID: 10.2217/fon.16.10)
Pacini F, Fugazzola L, Lippi F et al (1992) Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses: a clue to the diagnosis of metastatic differentiated thyroid cancer. J Clin Endocrinol Metab 74:1401–1404. (PMID: 1592886)
Marotta V, Sapio MR, Guerra A, Vitale M (2011) BRAF mutation in cytology samples as a diagnostic tool for papillary thyroid carcinoma. Expert Opin Med Diagn 5:277–290. (PMID: 10.1517/17530059.2011.575058)
Grant Information:: 2020A1515010098 Guangdong Basic and Applied Basic Research Foundation; 2020A1515011374 Guangdong Basic and Applied Basic Research Foundation; A2019116 the Medical Scientific Research Foundation of Guangdong Province, China
Contributed Indexing:: Keywords: Biopsy, Fine needle; Differentiated thyroid carcinoma; Lymph nodes; Meta-analysis; Thyroglobulin
Substance Nomenclature:: 9010-34-8 (Thyroglobulin)
Entry Date(s):: Date Created: 20201030 Date Completed: 20210415 Latest Revision: 20210415
Update Code:: 20240105
DOI:: 10.1007/s00330-020-07400-9
PMID:: 33125564
: Czasopismo naukowe

Full Text Finder

Objectives: Ultrasound (US)-guided fine needle aspiration cytology (FNAC) and thyroglobulin measurement (FNA-Tg) are two common methods for confirming lymph node metastases (LNM) in patients with differentiated thyroid carcinoma (DTC). This study aimed at comparing the diagnostic performance of FNAC, FNA-Tg alone, and in combination by means of a meta-analysis.
Methods: Eligible articles were selected according to predefined criteria, and their quality was evaluated as per the QUADAS-2 checklist. We calculated pooled sensitivity (Se), specificity (Sp), positive/negative likelihood ratio, and diagnostic odds ratio (DOR), and plotted the summary receiver operating characteristic (SROC) curve using the Meta-DiSc1.4 software.
Results: Twenty-one studies pooling 1662 malignant and 1279 benign LNs from 2712 patients with DTC were included. The results showed that FNAC was more specific (pooled Sp, 0.98) while FNA-Tg was more sensitive (pooled Se, 0.94). FNAC and FNAC+FNA-Tg performed better postoperatively than FNA-Tg, while FNA-Tg performed better preoperatively. The combination of FNAC and FNA-Tg could achieve a better diagnostic performance than each alone (DOR 446.00, area under the curve [AUC] 0.9862), no matter preoperatively (DOR 378.14, AUC 0.9879) or postoperatively (DOR 788.72, AUC 0.9930). Besides, the combination of FNAC and FNA-Tg/serum-Tg ratio obtained a higher Sp (0.98) than the combination of FNAC and FNA-Tg.
Conclusion: The addition of FNA-Tg, especially the FNA-Tg/serum-Tg ratio, to FNAC could increase the diagnostic performance of LNM in both preoperative and postoperative patients with DTC. Since one test or test combinations could perform differently according to the clinical situation, the best-fitting test should be chosen accordingly.
Key Points: • FNAC is more specific than FNA-Tg while FNA-Tg is more sensitive than FNAC. • The combination of FNAC and FNA-Tg could achieve a better diagnostic performance than either alone, no matter preoperatively or postoperatively. • The combination of FNAC and FNA-Tg/serum-Tg ratio could reach a higher Sp than the combination of FNAC and FNA-Tg.

Informacja