The diagnostic value of thyroglobulin in fine-needle aspiration of metastatic lymph nodes in patients with papillary thyroid cancer and its influential factors

Surg Oncol. 2021 Dec;39:101666. doi: 10.1016/j.suronc.2021.101666. Epub 2021 Sep 25.


Thyroglobulin (Tg) measurement in fine-needle aspiration (FNA-Tg) has proved to be an excellent tool to identify metastatic cervical lymph nodes (CLN) before or after surgery for papillary thyroid cancer (PTC). The diagnostic value of FNA-Tg for metastatic CLN in PTC patients is higher than that of ultrasound (US) and fine-needle aspiration cytology (FNAC), especially for small or cystic LN. The combination of FNAC and FNA-Tg can provide nearly 100% diagnostic sensitivity and specificity for CLN metastasis. However, the cutoff values of FNA-Tg for metastatic CLN have not been standardized, and the reported cutoff values of FNA-Tg range from 0.2 ng/ml to 77 ng/ml because of the differences in study samples, Tg measurement methods, Tg assays kits, etc. Serum anti-thyroglobulin antibody level, serum thyroglobulin level, the presence or absence of thyroid glands, and the characteristics of CLN may be factors affecting the accuracy of FNA-Tg. This review summarizes the recent research on the application of FNA-Tg in the diagnosis of metastatic LN in PTC and provides a reliable basis for the clinical diagnosis of cervical lymph node metastasis.

Keywords: Fine-needle aspiration; Lymph nodes; Metastasis; Papillary thyroid carcinoma; Thyroglobulin; Ultrasound.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / blood
  • Biopsy, Fine-Needle
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis / diagnosis*
  • Sensitivity and Specificity
  • Thyroglobulin / blood*
  • Thyroid Cancer, Papillary / blood*


  • Biomarkers, Tumor
  • Thyroglobulin