| Objective: By analyzing the data of thyroglobulin(FNA-Tg)in the eluent of cervical metastatic lymph nodes of papillary thyroid carcinoma and comparing the diagnostic efficiency,the best diagnostic truncation value of FNA-Tg in the presence of thyroid tissue and without thyroid tissue was obtained.Methods: The patients who underwent FNAC and FNA-Tg measurement for suspected cervical lymph node enlargement were divided into three groups: preoperative thyroid group,subtotal thyroid resection group,and total thyroid resection group.Non-parameter Kruskal-Wallis test was used to compare whether the FNA-Tg value between the three groups was statistically different.Receiver operating curves of FNA-Tg in different groups were constructed to obtain the optimal diagnostic cut-off value of FNA-Tg in different thyroid tissue states.At the same time,the diagnostic cutoff values in other studies were analyzed and compared in this study,and the best diagnostic cutoff values were obtained.The influence of other possible interfering factors on the diagnostic cutoff value was analyzed,and the diagnostic efficacy of FNAC,FNA-Tg and the combination of FNA-Tg and FNA-Tg on suspected cervical metastatic lymph nodes was analyzed.Results: A total of 465 patients with papillary thyroid carcinoma and 517 lymph nodes were included in this study.Nonparametric Kruskal-Wallis test was performed on the FNATg values of the preoperative thyroid group,the subtotal thyroid resection group and the total thyroid resection group.The results showed that there were statistical differences in FNA-Tg values between the preoperative group and the total thyroidectomy group(Z=4.891,P<0.05),and there were also statistical differences in FNA-Tg values between the subtotal thyroidectomy group and the total thyroidectomy group(Z=2.601,P<0.05).There was no statistical difference in FNA-Tg values between the preoperative thyroid group and the subtotal thyroid resection group(Z=0.717,P>0.05).Thus,all samples were regrouped into groups with thyroid tissue(including 443 lymph nodes in the preoperative and subtotal thyroidectomy groups)and without thyroid tissue(74 lymph nodes in the total thyroidectomy group,60 patients).In the presence of thyroid tissue,the optimal diagnostic cut-off value of FNA-Tg was 19.4 ng/ m L,and the area under the curve was 0.946.The optimal diagnostic cutoff value of thyroid tissue free group was 1.2 ng/ m L,and the area under the curve was 0.933.After analyzing and comparing the diagnostic cutoff values of multiple groups,the best diagnostic efficiency was still 19.4ng/ml and 1.2 ng/ml in this study.At the same time,the diagnostic value of FNA-Tg/STG >1 in some patients was analyzed.The diagnostic efficacy of Tg Ab and serum thyrotropin content in combination with FNAC and FNA-Tg was higher than that of FNA-Tg alone.Conclusion: The influential factors of FNA-Tg are still controversial,and the optimal cutoff value of FNA-Tg can be determined based on the presence or absence of thyroid tissue.And FNA-Tg can be used as an important auxiliary method for diagnosing cervical metastatic LNs of thyroid cancer. |
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