Fine-needle aspiration washout fluid for measuring thyroglobulin and fine-needle aspiration cytology in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma: a Meta-analysis / 肿瘤研究与临床

ABSTRACT

Objective:To systematically evaluate the diagnostic value of fine-needle aspiration washout fluid for measuring thyroglobulin (FNA-Tg) and fine-needle aspiration cytology (FNAC) in cervical lymph node metastasis of papillary thyroid carcinoma.Methods:Chinese Journal Full-Text Database, Wanfang Database, VIP Chinese Science and Technology Journal Database and other databases from January 2016 to December 2020 were retrieved. And then diagnostic trials from the databases regarding the comparison of FNA-Tg and FNAC in the diagnosis of papillary thyroid carcinoma with neck lymph node metastasis based on the histopathological diagnosis as the gold standard were included. The literatures were screened out according to the diagnostic test inclusion criteria recommended by the Cochrane Collaboration Screening and Diagnostic Test Methods Group; and then the quality of the included literatures was evaluated and feature information was extracted. Review Manager 5.0 and MetaDiSc software were used to conduct Meta analysis, and a summary receiver operating characteristic (SROC) curve of FNAC and FNA-Tg in the diagnosis of lymph node metastasis was drawn to calculate the area under the curve and to judge the diagnostic efficacy.Results:A total of 19 articles and 2 792 cervical lymph nodes were finally included. The sensitivity of FNAC and FNA-Tg in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma was 0.80 (95% CI 0.78-0.81) and 0.92 (95% CI 0.91-0.93), respectively; the specificity was 0.93 (95% CI 0.92-0.95) and 0.91(95% CI 0.89-0.93); the diagnostic odds ratio was 51.55 (95% CI 38.61-68.81) and 110.03 (95% CI 82.18-147.32), respectively; the areas under the SROC curve was 0.900 and 0.968, respectively. Conclusions:The accuracy of FNA-Tg in the diagnosis of cervical lymph node metastasis of papillary thyroid carcinoma is higher than that of FNAC. FNA-Tg can be used as an important diagnosis supplement to FNAC and it can be widely used in clinical practice.