Neck is an early location of lymphnode metastases and/or local recurrences from differentiated (DTC) and medullary (MTC) thyroid carcinonas. Diagnosis is mainly based on neck ultrasound and on cytological examination of ultrasound-guided fine needle aspiration biopsy (FNAB) from the suspect lesion, although this procedure accounts for 5-10% false negative results. Since thyroglobulin (Tg) is a sensitive and specific marker of DTC after total thyroidectomy, Tg assay in FNAB needle washout fluid (Tg-FNAB) has been proposed since early ‘90s to obtain diagnostic sensitivities and specificities near to 100%. Moreover, studies carried out by our group have shown that Tg-FNAB displays the same diagnostic values in patients with circulating anti-Tg antibodies (TgAb), who were previously excluded for the potential interference exerted by TgAb on Tg assay. Serum calcitonin (CT) is an exquisitely sensitive and specific marker of MTC even before thyroidectomy, but no data were until now available on the diagnostic usefulness of CT assay in the needle washout fluid of FNAB (CT-FNAB) in patients with MTC and suspect cervical masses. We have recently shown that, similarly to Tg-FNAB, CT-FNAB represents a highly sensitive and specific diagnostic procedure for the identification of lymphnode metastases and local recurrences in MTC. Taken together, assay of Tg and CT in FNAB fluid washout represents a simple and valuable diagnostic tool to be associated to ultrasound and cytology in the early diagnosis of lymph-node metastases and/or local recurrences in patients with thyroid tumors.
Utilità del dosaggio della tireoglobulina e della calcitonina nel liquido di lavaggio degli agoaspirati per la diagnosi precoce delle metastasi linfonodali cervicali e delle recidive postoperatorie dei tumori della tiroide
BOI, FRANCESCO;MARIOTTI, STEFANO
2007-01-01
Abstract
Neck is an early location of lymphnode metastases and/or local recurrences from differentiated (DTC) and medullary (MTC) thyroid carcinonas. Diagnosis is mainly based on neck ultrasound and on cytological examination of ultrasound-guided fine needle aspiration biopsy (FNAB) from the suspect lesion, although this procedure accounts for 5-10% false negative results. Since thyroglobulin (Tg) is a sensitive and specific marker of DTC after total thyroidectomy, Tg assay in FNAB needle washout fluid (Tg-FNAB) has been proposed since early ‘90s to obtain diagnostic sensitivities and specificities near to 100%. Moreover, studies carried out by our group have shown that Tg-FNAB displays the same diagnostic values in patients with circulating anti-Tg antibodies (TgAb), who were previously excluded for the potential interference exerted by TgAb on Tg assay. Serum calcitonin (CT) is an exquisitely sensitive and specific marker of MTC even before thyroidectomy, but no data were until now available on the diagnostic usefulness of CT assay in the needle washout fluid of FNAB (CT-FNAB) in patients with MTC and suspect cervical masses. We have recently shown that, similarly to Tg-FNAB, CT-FNAB represents a highly sensitive and specific diagnostic procedure for the identification of lymphnode metastases and local recurrences in MTC. Taken together, assay of Tg and CT in FNAB fluid washout represents a simple and valuable diagnostic tool to be associated to ultrasound and cytology in the early diagnosis of lymph-node metastases and/or local recurrences in patients with thyroid tumors.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
