Ultrasound Combined With FNA-Tg Predicts the Lateral Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma.

Objective: The present study analyzed typical ultrasound manifestations and fine-needle aspiration thyroglobulin (FNA-Tg) levels to investigate their association with cervical lymph node metastasis in patients with papillary thyroid carcinoma (PTC).

Methods: The data of 139 PTC patients with ultrasonically suspected cervical lymph node metastasis treated in our hospital from December 2022 to November 2023 were retrospectively analyzed. All included patients underwent ultrasound examination of cervical lymph nodes, fine needle aspiration cytology (FNA-C) examination, and ultrasound-guided lymph node aspiration eluent thyroglobulin (FNA-Tg). Typical ultrasound signs for diagnosing cervical lymph node metastasis (US-M) and ultrasound-guided FNA-Tg for diagnosing cervical lymph node metastasis were compared and analyzed.

Results: Results indicate that 71 patients were diagnosed with cervical lymph node metastasis through surgery and subsequently included in the metastatic group; the remaining 68 patients were included in the nonmetastatic group. The FNA-Tg value in the metastatic group was higher than that in the nonmetastatic group; the difference was significant (p < 0.001). The AUC values for diagnosing cervical lymph node metastasis in PTC patients using US-M, FNA-Tg, and US-M+FNA-Tg were 0.854, 0.927, and 0.952. When the cut-off value of FNA-Tg was 229.1 ng/mL, the sensitivity and specificity for diagnosing cervical lymph node metastasis in PTC patients were 84.5% and 89.5%.

Conclusions: Ultrasound-guided FNA-Tg level is closely related to cervical lymph node metastasis in patients with PTC. The combination of ultrasound examination and FNA-Tg testing significantly enhances the accuracy of predicting lateral cervical lymph node metastasis in patients with PTC.