Diagnostic value of thyroglobulin measurement in fine-needle aspiration biopsy for detecting metastatic lymph nodes in patients with papillary thyroid carcinoma

Langenbecks Arch Surg. 2011 Jan;396(1):77-81. doi: 10.1007/s00423-010-0723-1. Epub 2010 Oct 30.


Purpose: We aimed to compare the diagnostic value of fine-needle aspiration cytology (FNAC) and fine-needle aspiration thyroglobulin measurements (FNA-Tg) for detecting cervical lymph node metastases from differentiated thyroid carcinomas.

Methods: This prospective study included 225 patients with neck node metastases or recurrences of papillary thyroid carcinoma. From the 225 patients, 255 lymph nodes were evaluated by FNAC and FNA-Tg. Final diagnoses confirmed by histological examination were compared to preoperative FNAC and FNA-Tg results.

Results: FNAC correctly diagnosed 212 metastatic lymph nodes but failed to diagnose 43 of them. FNA-Tg correctly diagnosed 253 metastatic lymph nodes but failed to diagnose two of them. FNA-Tg levels showed 100% sensitivity, 96% specificity, 99% diagnostic accuracy, a 99% positive predictive value (PPV) and a 100% negative predictive value (NPV) with a threshold level of FNA-Tg with a diagnostic accuracy 28.5 ng/ml. The specificity, diagnostic accuracy, PPV and NPV of FNA-Tg were significantly higher than those of FNAC.

Conclusion: FNA-Tg measurement can be performed safely for the detection of lymph node metastasis in patients with differentiated thyroid carcinomas.

MeSH terms

  • Adenocarcinoma, Papillary / pathology*
  • Adenocarcinoma, Papillary / surgery
  • Adult
  • Aged
  • Biomarkers, Tumor / analysis*
  • Biopsy, Fine-Needle / methods*
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Immunoradiometric Assay
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis / diagnostic imaging
  • Lymphatic Metastasis / pathology*
  • Male
  • Middle Aged
  • Neck Dissection
  • Predictive Value of Tests
  • Prospective Studies
  • Thyroglobulin / analysis*
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / surgery
  • Thyroidectomy
  • Ultrasonography, Interventional
  • Young Adult


  • Biomarkers, Tumor
  • Thyroglobulin