Serum Antithyroglobulin Antibodies Interfere with Thyroglobulin Detection in Fine-Needle Aspirates of Metastatic Neck Nodes in Papillary Thyroid Carcinoma
Context: It is recommended to measure thyroglobulin (Tg) levels in the needle washout fluids from fine-needle aspirations (FNAs) in patients with papillary thyroid carcinoma (PTC) who have ultrasonographically suspicious metastatic lymph nodes (LNs). However, it is not clear whether serum anti-Tg an...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2013-01, Vol.98 (1), p.153-160 |
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| creator | Jeon, Min Ji Park, Jee Won Han, Ji Min Yim, Ji Hye Song, Dong Eun Gong, Gyungyub Kim, Tae Yong Baek, Jung Hwan Lee, Jeong Hyun Shong, Young Kee Kim, Won Bae |
| description | Context:
It is recommended to measure thyroglobulin (Tg) levels in the needle washout fluids from fine-needle aspirations (FNAs) in patients with papillary thyroid carcinoma (PTC) who have ultrasonographically suspicious metastatic lymph nodes (LNs). However, it is not clear whether serum anti-Tg antibodies (TgAbs) interfere with the detection of Tg in needle washout fluids from FNAs (FNA-Tg).
Objective:
The objective of the study was to evaluate the influence of serum TgAbs on FNA-Tg detection.
Design and Settings:
This retrospective observational cohort study enrolled 207 patients with conventional PTC in whom FNA-Tg values had been measured. All patients initially underwent total thyroidectomy and remnant ablation. FNA-Tg levels were measured from ultrasonographically suspicious metastatic LNs of 0.5 cm or greater in the longest diameter.
Results:
From 207 patients, 263 LNs were evaluated. Final histopathology was available for 92 LNs, of which 88 (96%) were malignant. FNA-Tg levels were lower in the LNs from serum TgAb-positive patients than in those from TgAb-negative patients (P < 0.001). In four of 13 metastatic LNs from TgAb-positive patients, the FNA-Tg levels were below 10 μg/liter including one in which both FNA-Tg and serum-stimulated Tg levels were below 1 μg/liter and stained positively for Tg in pathology. There was also one malignant LN with negative for FNA-Tg, serum-stimulated Tg, and serum TgAb but that nonetheless stained intensely for Tg. However, there were no malignant LNs with both negative cytology and negative FNA-Tg. A diagnosis based on FNA-Tg had a lower sensitivity and negative predictive value in the TgAb-positive group than in the TgAb-negative group.
Conclusion:
FNA-Tg measurement is highly reliable in the diagnosis of neck metastases in PTC patients, even in cases of negative-stimulated Tg or positive TgAb. However, high-serum TgAb levels could interfere with FNA-Tg measurements and thereby result in falsely low FNA-Tg levels. |
| doi_str_mv | 10.1210/jc.2012-2369 |
| format | Article |
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It is recommended to measure thyroglobulin (Tg) levels in the needle washout fluids from fine-needle aspirations (FNAs) in patients with papillary thyroid carcinoma (PTC) who have ultrasonographically suspicious metastatic lymph nodes (LNs). However, it is not clear whether serum anti-Tg antibodies (TgAbs) interfere with the detection of Tg in needle washout fluids from FNAs (FNA-Tg).
Objective:
The objective of the study was to evaluate the influence of serum TgAbs on FNA-Tg detection.
Design and Settings:
This retrospective observational cohort study enrolled 207 patients with conventional PTC in whom FNA-Tg values had been measured. All patients initially underwent total thyroidectomy and remnant ablation. FNA-Tg levels were measured from ultrasonographically suspicious metastatic LNs of 0.5 cm or greater in the longest diameter.
Results:
From 207 patients, 263 LNs were evaluated. Final histopathology was available for 92 LNs, of which 88 (96%) were malignant. FNA-Tg levels were lower in the LNs from serum TgAb-positive patients than in those from TgAb-negative patients (P < 0.001). In four of 13 metastatic LNs from TgAb-positive patients, the FNA-Tg levels were below 10 μg/liter including one in which both FNA-Tg and serum-stimulated Tg levels were below 1 μg/liter and stained positively for Tg in pathology. There was also one malignant LN with negative for FNA-Tg, serum-stimulated Tg, and serum TgAb but that nonetheless stained intensely for Tg. However, there were no malignant LNs with both negative cytology and negative FNA-Tg. A diagnosis based on FNA-Tg had a lower sensitivity and negative predictive value in the TgAb-positive group than in the TgAb-negative group.
Conclusion:
FNA-Tg measurement is highly reliable in the diagnosis of neck metastases in PTC patients, even in cases of negative-stimulated Tg or positive TgAb. However, high-serum TgAb levels could interfere with FNA-Tg measurements and thereby result in falsely low FNA-Tg levels.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2012-2369</identifier><identifier>PMID: 23144473</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Adolescent ; Adult ; Aged ; Autoantibodies - adverse effects ; Autoantibodies - blood ; Autoantibodies - pharmacology ; Biological and medical sciences ; Biopsy, Fine-Needle ; Blood Chemical Analysis ; Carcinoma - blood ; Carcinoma - diagnosis ; Carcinoma - diagnostic imaging ; Carcinoma - pathology ; Carcinoma, Papillary ; Child ; Cohort Studies ; Endocrinopathies ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Humans ; Lymph Nodes - pathology ; Lymphatic Metastasis ; Male ; Malignant tumors ; Medical sciences ; Middle Aged ; Neck ; Retrospective Studies ; Thyroglobulin - analysis ; Thyroglobulin - immunology ; Thyroid Cancer, Papillary ; Thyroid Function Tests - methods ; Thyroid Neoplasms - blood ; Thyroid Neoplasms - diagnosis ; Thyroid Neoplasms - diagnostic imaging ; Thyroid Neoplasms - pathology ; Thyroid. Thyroid axis (diseases) ; Ultrasonography ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology ; Young Adult</subject><ispartof>The journal of clinical endocrinology and metabolism, 2013-01, Vol.98 (1), p.153-160</ispartof><rights>Copyright © 2013 by The Endocrine Society</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4481-9c98155717754fae6d89e194ad117845da9048ffb9df7f4e4e754e79123c6a723</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,4010,27904,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27073487$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23144473$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jeon, Min Ji</creatorcontrib><creatorcontrib>Park, Jee Won</creatorcontrib><creatorcontrib>Han, Ji Min</creatorcontrib><creatorcontrib>Yim, Ji Hye</creatorcontrib><creatorcontrib>Song, Dong Eun</creatorcontrib><creatorcontrib>Gong, Gyungyub</creatorcontrib><creatorcontrib>Kim, Tae Yong</creatorcontrib><creatorcontrib>Baek, Jung Hwan</creatorcontrib><creatorcontrib>Lee, Jeong Hyun</creatorcontrib><creatorcontrib>Shong, Young Kee</creatorcontrib><creatorcontrib>Kim, Won Bae</creatorcontrib><title>Serum Antithyroglobulin Antibodies Interfere with Thyroglobulin Detection in Fine-Needle Aspirates of Metastatic Neck Nodes in Papillary Thyroid Carcinoma</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Context:
It is recommended to measure thyroglobulin (Tg) levels in the needle washout fluids from fine-needle aspirations (FNAs) in patients with papillary thyroid carcinoma (PTC) who have ultrasonographically suspicious metastatic lymph nodes (LNs). However, it is not clear whether serum anti-Tg antibodies (TgAbs) interfere with the detection of Tg in needle washout fluids from FNAs (FNA-Tg).
Objective:
The objective of the study was to evaluate the influence of serum TgAbs on FNA-Tg detection.
Design and Settings:
This retrospective observational cohort study enrolled 207 patients with conventional PTC in whom FNA-Tg values had been measured. All patients initially underwent total thyroidectomy and remnant ablation. FNA-Tg levels were measured from ultrasonographically suspicious metastatic LNs of 0.5 cm or greater in the longest diameter.
Results:
From 207 patients, 263 LNs were evaluated. Final histopathology was available for 92 LNs, of which 88 (96%) were malignant. FNA-Tg levels were lower in the LNs from serum TgAb-positive patients than in those from TgAb-negative patients (P < 0.001). In four of 13 metastatic LNs from TgAb-positive patients, the FNA-Tg levels were below 10 μg/liter including one in which both FNA-Tg and serum-stimulated Tg levels were below 1 μg/liter and stained positively for Tg in pathology. There was also one malignant LN with negative for FNA-Tg, serum-stimulated Tg, and serum TgAb but that nonetheless stained intensely for Tg. However, there were no malignant LNs with both negative cytology and negative FNA-Tg. A diagnosis based on FNA-Tg had a lower sensitivity and negative predictive value in the TgAb-positive group than in the TgAb-negative group.
Conclusion:
FNA-Tg measurement is highly reliable in the diagnosis of neck metastases in PTC patients, even in cases of negative-stimulated Tg or positive TgAb. However, high-serum TgAb levels could interfere with FNA-Tg measurements and thereby result in falsely low FNA-Tg levels.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Autoantibodies - adverse effects</subject><subject>Autoantibodies - blood</subject><subject>Autoantibodies - pharmacology</subject><subject>Biological and medical sciences</subject><subject>Biopsy, Fine-Needle</subject><subject>Blood Chemical Analysis</subject><subject>Carcinoma - blood</subject><subject>Carcinoma - diagnosis</subject><subject>Carcinoma - diagnostic imaging</subject><subject>Carcinoma - pathology</subject><subject>Carcinoma, Papillary</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Endocrinopathies</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Malignant tumors</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neck</subject><subject>Retrospective Studies</subject><subject>Thyroglobulin - analysis</subject><subject>Thyroglobulin - immunology</subject><subject>Thyroid Cancer, Papillary</subject><subject>Thyroid Function Tests - methods</subject><subject>Thyroid Neoplasms - blood</subject><subject>Thyroid Neoplasms - diagnosis</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid. Thyroid axis (diseases)</subject><subject>Ultrasonography</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><subject>Young Adult</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkcGO0zAQhi0EYsvCjTPyBYkDWWzHiZNjVVhYaSlILBI3y3XG1N00ztqOqn0VnpYpKSAkfLHH_v6Z8fyEPOfsggvO3uzshWBcFKKs2wdkwVtZFYq36iFZMCZ40Srx7Yw8SWnHGJeyKh-TM1HiSapyQX58gTjt6XLIPm_vY_jeh83U--HXzSZ0HhK9GjJEBxHoASF68w_3FjLY7MNAMbj0AxRrgK4HukyjjyajPjj6EbJJ2WRv6RrsLV2HDh9Q8dmMvu9NvJ_T-o6uTLR-CHvzlDxypk_w7LSfk6-X725WH4rrT--vVsvrwkrZ4P9s2_CqUlypSjoDdde0gFMwHeeqkVVnWiYb5zZt55STIAE5UC0Xpa2NEuU5eTXnHWO4myBlvffJAnY1QJiS5kKVoua8kYi-nlEbQ0oRnB6j32P3mjN9dEPvrD66oY9uIP7ilHna7KH7A_8ePwIvT4BJ1vQumsH69JdTTJWyUcjJmTuEHr1It_10gKi3YPq81QyXrFVTYOWScYwKdrQeZeUsg6ELNqI5Y4SU9C5MccCR_r_rn3x2tPk</recordid><startdate>201301</startdate><enddate>201301</enddate><creator>Jeon, Min Ji</creator><creator>Park, Jee Won</creator><creator>Han, Ji Min</creator><creator>Yim, Ji Hye</creator><creator>Song, Dong Eun</creator><creator>Gong, Gyungyub</creator><creator>Kim, Tae Yong</creator><creator>Baek, Jung Hwan</creator><creator>Lee, Jeong Hyun</creator><creator>Shong, Young Kee</creator><creator>Kim, Won Bae</creator><general>Endocrine Society</general><general>Copyright by The Endocrine Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201301</creationdate><title>Serum Antithyroglobulin Antibodies Interfere with Thyroglobulin Detection in Fine-Needle Aspirates of Metastatic Neck Nodes in Papillary Thyroid Carcinoma</title><author>Jeon, Min Ji ; Park, Jee Won ; Han, Ji Min ; Yim, Ji Hye ; Song, Dong Eun ; Gong, Gyungyub ; Kim, Tae Yong ; Baek, Jung Hwan ; Lee, Jeong Hyun ; Shong, Young Kee ; Kim, Won Bae</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4481-9c98155717754fae6d89e194ad117845da9048ffb9df7f4e4e754e79123c6a723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Autoantibodies - adverse effects</topic><topic>Autoantibodies - blood</topic><topic>Autoantibodies - pharmacology</topic><topic>Biological and medical sciences</topic><topic>Biopsy, Fine-Needle</topic><topic>Blood Chemical Analysis</topic><topic>Carcinoma - blood</topic><topic>Carcinoma - diagnosis</topic><topic>Carcinoma - diagnostic imaging</topic><topic>Carcinoma - pathology</topic><topic>Carcinoma, Papillary</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Endocrinopathies</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Malignant tumors</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neck</topic><topic>Retrospective Studies</topic><topic>Thyroglobulin - analysis</topic><topic>Thyroglobulin - immunology</topic><topic>Thyroid Cancer, Papillary</topic><topic>Thyroid Function Tests - methods</topic><topic>Thyroid Neoplasms - blood</topic><topic>Thyroid Neoplasms - diagnosis</topic><topic>Thyroid Neoplasms - diagnostic imaging</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Thyroid. Thyroid axis (diseases)</topic><topic>Ultrasonography</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jeon, Min Ji</creatorcontrib><creatorcontrib>Park, Jee Won</creatorcontrib><creatorcontrib>Han, Ji Min</creatorcontrib><creatorcontrib>Yim, Ji Hye</creatorcontrib><creatorcontrib>Song, Dong Eun</creatorcontrib><creatorcontrib>Gong, Gyungyub</creatorcontrib><creatorcontrib>Kim, Tae Yong</creatorcontrib><creatorcontrib>Baek, Jung Hwan</creatorcontrib><creatorcontrib>Lee, Jeong Hyun</creatorcontrib><creatorcontrib>Shong, Young Kee</creatorcontrib><creatorcontrib>Kim, Won Bae</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jeon, Min Ji</au><au>Park, Jee Won</au><au>Han, Ji Min</au><au>Yim, Ji Hye</au><au>Song, Dong Eun</au><au>Gong, Gyungyub</au><au>Kim, Tae Yong</au><au>Baek, Jung Hwan</au><au>Lee, Jeong Hyun</au><au>Shong, Young Kee</au><au>Kim, Won Bae</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum Antithyroglobulin Antibodies Interfere with Thyroglobulin Detection in Fine-Needle Aspirates of Metastatic Neck Nodes in Papillary Thyroid Carcinoma</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2013-01</date><risdate>2013</risdate><volume>98</volume><issue>1</issue><spage>153</spage><epage>160</epage><pages>153-160</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Context:
It is recommended to measure thyroglobulin (Tg) levels in the needle washout fluids from fine-needle aspirations (FNAs) in patients with papillary thyroid carcinoma (PTC) who have ultrasonographically suspicious metastatic lymph nodes (LNs). However, it is not clear whether serum anti-Tg antibodies (TgAbs) interfere with the detection of Tg in needle washout fluids from FNAs (FNA-Tg).
Objective:
The objective of the study was to evaluate the influence of serum TgAbs on FNA-Tg detection.
Design and Settings:
This retrospective observational cohort study enrolled 207 patients with conventional PTC in whom FNA-Tg values had been measured. All patients initially underwent total thyroidectomy and remnant ablation. FNA-Tg levels were measured from ultrasonographically suspicious metastatic LNs of 0.5 cm or greater in the longest diameter.
Results:
From 207 patients, 263 LNs were evaluated. Final histopathology was available for 92 LNs, of which 88 (96%) were malignant. FNA-Tg levels were lower in the LNs from serum TgAb-positive patients than in those from TgAb-negative patients (P < 0.001). In four of 13 metastatic LNs from TgAb-positive patients, the FNA-Tg levels were below 10 μg/liter including one in which both FNA-Tg and serum-stimulated Tg levels were below 1 μg/liter and stained positively for Tg in pathology. There was also one malignant LN with negative for FNA-Tg, serum-stimulated Tg, and serum TgAb but that nonetheless stained intensely for Tg. However, there were no malignant LNs with both negative cytology and negative FNA-Tg. A diagnosis based on FNA-Tg had a lower sensitivity and negative predictive value in the TgAb-positive group than in the TgAb-negative group.
Conclusion:
FNA-Tg measurement is highly reliable in the diagnosis of neck metastases in PTC patients, even in cases of negative-stimulated Tg or positive TgAb. However, high-serum TgAb levels could interfere with FNA-Tg measurements and thereby result in falsely low FNA-Tg levels.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>23144473</pmid><doi>10.1210/jc.2012-2369</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0021-972X 1945-7197 |
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| source | MEDLINE; Journals@Ovid Complete; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Autoantibodies - adverse effects Autoantibodies - blood Autoantibodies - pharmacology Biological and medical sciences Biopsy, Fine-Needle Blood Chemical Analysis Carcinoma - blood Carcinoma - diagnosis Carcinoma - diagnostic imaging Carcinoma - pathology Carcinoma, Papillary Child Cohort Studies Endocrinopathies Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Humans Lymph Nodes - pathology Lymphatic Metastasis Male Malignant tumors Medical sciences Middle Aged Neck Retrospective Studies Thyroglobulin - analysis Thyroglobulin - immunology Thyroid Cancer, Papillary Thyroid Function Tests - methods Thyroid Neoplasms - blood Thyroid Neoplasms - diagnosis Thyroid Neoplasms - diagnostic imaging Thyroid Neoplasms - pathology Thyroid. Thyroid axis (diseases) Ultrasonography Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology Young Adult |
| title | Serum Antithyroglobulin Antibodies Interfere with Thyroglobulin Detection in Fine-Needle Aspirates of Metastatic Neck Nodes in Papillary Thyroid Carcinoma |
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