Evaluation of relevant indicators in the diagnosis of cervical lymph node metastasis in papillary thyroid cancer.

BACKGROUND

This study aims to investigate the role of FNAC, FNA-Tg, the ratio of FNA-Tg to serum Tg, and their combined application in evaluating cervical lymph node metastasis in papillary thyroid cancer (PTC) to identify a more effective diagnostic strategy.

METHODS

A total of 284 patients with 319 cervical lymph node (LN) samples enrolled from January 2022 to March 2024 were retrospectively analyzed. All patients underwent thyroid surgery and neck lymph node dissection. Relevant indicators of thyroid status were collected from patients.

RESULTS

Serum Tg levels were associated with FNA-Tg levels. Compared with FNA-Tg alone, the ratio of FNA-Tg to serum Tg also played an important role in the diagnosis of lymph node metastasis. Moreover, when FNA-Tg or the ratio was combined with FNAC, diagnostic sensitivity, specificity, accuracy, and positive predictive value for detecting metastatic PTC lymph nodes were significantly higher, with statistically significant differences.

CONCLUSION

Both FNA-Tg levels and the ratio of FNA-Tg to serum Tg can enhance the diagnostic efficacy of FNAC for cervical LN metastasis in PTC and demonstrate high diagnostic value. They are superior to FNAC alone. When combined with FNAC, they can further improve diagnostic efficiency. A higher positive rate in preoperative cervical lymph node diagnosis can not only provide a stable basis for selecting the subsequent surgical approach but also play an important role in pathological staging and prognostic follow-up.