| Objective:To investigate the ratio of FNA-Tg（washout fluid thyroglobulin in fine-needle aspiration）to serum Tg,FNA-Tg>1 ng/m L and FNA-Tg>10 ng/m L in diagnosing cervical lymph node metastasis after the surgery for differentiated thyroid carcinoma and 131I treatment,and calculate the optimal diagnostic threshold,and to analyze factors affecting cervical lymph node metastasis.Methods:101 patients who were diagnosed with DTC from November 2018 to March 2021 and underwent total thyroidectomy and received131I treatment at the same time were selected.A total of 114 suspicious lymph nodes were detected via ultrasound.The pathological results of those after lymph node dissection were used as the gold standard to compare the efficacy of FNA-Tg>1 ng/m L,FNA-Tg>10 ng/m L and FNA-Tg/serum Tg>1 in diagnosing lymph node metastasis.The receiver operating characteristic curve（ROC）was used to calculate the optimal thresholds of FNA-Tg/serum Tg for judging whether cervical lymph node metastasis occurred,and multivariate logistic regression was used to analyze the factors affecting the cervical lymph node metastasis in patients with DTC.Results:（1）The age、FNA-Tg and FNA-Tg/serm Tg level of patients in the lymph node metastasis-positive group were higher than those in the lymph node metastasis-negative group,and the difference was statistically significant（P=0.006、<0.001、<0.001）.（2）The sensitivity and false negative rate of FNA-Tg/serum Tg in diagnosing cervical lymph node metastasis in patients with DTC were higher than those of FNA-Tg>10（P=0.019、0.019）,while the specificity,accuracy and false positive rate had no statistical difference（P=0.755、0.178、0.755）;the sensitivity,accuracy and false-negative rate of FNA-Tg/serum Tg in diagnosing cervical lymph node metastasis in patients with DTC were higher than those of FNA-Tg>1（P=0.019、0.024、0.019）,while the specificity and false-positive rate had no statistical difference（P=0.293、0.293）;there was no statistical difference in the sensitivity,specificity,accuracy,false negative rate and false positive rate of FNA-Tg>1ng/m L and FNA-Tg>10 ng/m L in the diagnosing cervical lymph node metastasis in patients with DTC（P=1.000、0.176、0.347、1.000、0.176）.（3）When the FNA-Tg/serum Tg of 114 lymph nodes were analyzed by ROC curve according to lymph node metastasis-positive and metastasis-negative groups,the area under the curve was 0.905,the optimal diagnostic threshold was 1.02,the sensitivity was 93%,and the specificity was 93%.（4）Logistic regression analysis showed that age（OR=1.065,95%CI:1.006-1.128）,FNA-Tg（OR=1.009,95%CI:1.004-1.014）and FNA-Tg/serum Tg（OR=1.044,95%CI:1.005-1.084）were risk factors of cervical lymph node metastasis in patients with DTC.Conclusion:（1）FNA-Tg/serum Tg can improve the efficacy of FNA-Tg in diagnosing cervical lymph node metastasis to a certain extent for patients who followed up after the surgery for DTC and 131I treatment.（2）The patient’s age、FNA-Tg and FNA-Tg/serum Tg can be used as risk factors to predict whether the cervical lymph node metastasis occurs after the surgery for DTC and 131I treatment,which has important clinical significance for the diagnosis and treatment of patient’s suspicious lymph nodes. |
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