Analysis of ultrasonographic features of thyroid lymph nodes associated with positive thyroglobulin in fine needle aspiration eluent of metastatic lymph nodes

Abstract

Abstract:

Objective:To explore the ultrasonographic characteristics of lymph nodes associated with positive fine-needle aspiration thyroglobulin (FNA-Tg) in eluent for suspected metastatic lymph nodes of papillary thyroid carcinoma (PTC).Methods:A total of 87 patients with PTC who were treated between January 2019 and December 2021 were selected, with 109 suspected metastatic lymph nodes examined by fine needle aspiration cytology and detected for FNA-Tg. Those with FNA-Tg/serum Tg>1 was defined as metastastic lymph nodes, and with FNA-Tg/serum Tg≤1 was defined as non-metastastic lymph nodes. All suspicious lymph nodes had ultrasonographic signs of suspicious metastasis, including local hyperechogenicity, cystic change, absence of hilum, microcalcification, solbiati index <2, and marginal blood supply. Univariate and multivariate logistic regression were applied to analyze the correlation of these suspicious lymph node ultrasound signs with positive FNA-Tg.Results:Among 109 suspected metastatic lymph nodes, 30 lymph nodes were FNA-Tg negative and 79 were FNA-Tg positive. Among the ultrasonographic features of suspected metastatic lymph nodes, local hyperecho and cystic change were independent risk factors for positive FNA-Tg detection(P<0.05).Conclusions:For suspected metastatic lymph nodes with local hyperecho and cystic changes in conventional ultrasound, FNA-Tg determination can be performed along with fine needle aspiration cytology examination to improve the detection rate of PTC metastatic lymph nodes,providing more accurate diagnostic information for the clinic.

Key words:Lymphnodes,Thyroglobulin,Sonographic features

CLC Number:

KUANG Lijun, TAO Lingling, ZHAN Weiwei, LI Weiwei, FAN Jinfang, ZHOU Wei. Analysis of ultrasonographic features of thyroid lymph nodes associated with positive thyroglobulin in fine needle aspiration eluent of metastatic lymph nodes[J]. Journal of Diagnostics Concepts & Practice, 2023, 22(03): 255-260.

Figures/Tables5

Item	FNA-Tg（-）（n=30）	FNA-Tg（+）（n=79）	Pvalue
Sex			0.015
Male	10	47
Female	20	32
Age	39.30±11.35	38.35±11.29	0.422
FNA-Tg（ng/mL）	0.09(0.04-1.48)	1024(343-5 996)	<0.001
Serum Tg （ng/mL）	4.71(0.88-21.83)	10.58(3.78-27.99)	0.040
FT₃（pmol/L）	4.43±0.65	4.43±0.62	0.779
FT₄(pmol/L)	15.91±3.39	17.16±13.73	0.493
TSH（μIU/mL）	1.77±1.57	1.64±1.33	0.087
TgAb（IU/mL）	9.89(1.57-36.42)	3.46(1.76-18.99)	0.214

Table 1

Table 2

Analysis of ultrasonographic characteristics of lymph nodes between FNA-Tg negative group and positive group

Ultrasound features	FNA-Tg（-）（n=30）	FNA-Tg（+）（n=79）	Total （n=109）	χ²value	Pvalue
Solbiati index				0.403	0.525
<2	9	19	28
≥2	21	60	81
Absence of hilum				2.475	0.116
Yus	23	70	93
No	7	9	16
Hyperechoic content				11.267	0.001
Yes	3	35	38
No	27	44	71
Microcalcification				2.791	0.095
Yes	7	32	39
No	23	47	70
Lymph nodes with cystic content				16.451	<0.001
Yes	0	31	31
No	30	48	78
Peripheral hypervascularity				7.133	0.008
Yes	6	38	44
No	24	41	65

Table 2

Figure 1

Figure 2

Ultrasound features	B	S.E.	Wald	df	sig	Exp（B）	Exp（B）95%
Absence of hilum	0.440	0.736	0.358	1	0.550	1.552	0.367	6.564
Hyperechoic content	1.575	0.733	4.612	1	0.032	4.832	1.148	20.329
Microcalcification	0.734	0.600	1.497	1	0.221	2.084	0.643	6.755
Lymph nodes with cystic content	1.423	0.711	4.005	1	0.045	4.150	1.030	16.728
Peripheral hypervascularity	0.942	0.803	5.841	1	0.056	6.972	1.444	33.673

Table 3

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