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A Study on Serum Antithyroglobulin Antibodies Interference in Thyroglobulin Measurement in Fine-Needle Aspiration for Diagnosing Lymph Node Metastasis in Postoperative Patients.

AbstractPURPOSE:
Thyroglobulin measurement in fine-needle aspiration washout fluid (FNA-Tg) is widely used for detection of lymph node metastasis (LNM) in patients with papillary thyroid cancer (PTC). Recent studies suggested that serum anti-thyroglobulin antibodies (TgAbs) could interfere with FNA-Tg. We evaluated whether TgAbs can affect FNA-Tg when diagnosing LNM in postoperative patients with PTC.
METHODS:
From November 2006 to June 2011, a total of 239 LNs from 201 patients who underwent bilateral thyroidectomy and radioactive iodine ablation therapy were included. The interactions between FNA-Tgs and serum TgAbs, and diagnostic performances between FNA with additional FNA-Tg and FNA alone according to the presence of serum TgAbs were evaluated using the generalized linear mixed model and the bootstrap method.
RESULTS:
From 106 (44.4%) malignant and 133 (55.6%) benign LNs, there were 32 (13.4%) LNs with detectable serum TgAb levels and 207 (86.6%) LNs with undetectable serum TgAb levels. In logistic regression analysis, a significant negative interaction was observed between FNA-Tgs and serum TgAbs (p = 0.031). In the absence of serum TgAbs, the diagnostic performances were superior in the FNA with FNA-Tg than in the FNA only. However, in the presence of serum TgAbs, the diagnostic performances of the FNA with FNA-Tg were not significantly different from the FNA only, even with a different cutoff value of FNA-Tg.
CONCLUSIONS:
Serum TgAbs may interfere with FNA-Tg studies and caution is advised while analyzing FNA-Tg for detection of LNM in patients with PTC.
AuthorsHyun Joo Shin, Hye Sun Lee, Eun-Kyung Kim, Hee Jung Moon, Ji Hye Lee, Jin Young Kwak
JournalPloS one (PLoS One) Vol. 10 Issue 6 Pg. e0131096 ( 2015) ISSN: 1932-6203 [Electronic] United States
PMID26121598 (Publication Type: Journal Article)
Chemical References
  • Autoantibodies
  • anti-thyroglobulin
  • Thyroglobulin
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Autoantibodies (blood)
  • Biopsy, Fine-Needle
  • Female
  • Humans
  • Lymph Nodes (pathology)
  • Lymphatic Metastasis (diagnosis, pathology)
  • Male
  • Middle Aged
  • Postoperative Period
  • Thyroglobulin (blood)
  • Young Adult

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