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Endocrine Abstracts (2021) 73 AEP693 | DOI: 10.1530/endoabs.73.AEP693

ECE2021 Audio Eposter Presentations Thyroid (157 abstracts)

The value of serum thyroglobuline alteration after ultrasonography-guided fine-needle biopsy of suspicous cervical lymph nodes in the diagnosis of metastasis in patients with differentiated thyroid cancer

Fatma Dilek Dellal 1 , Cevdet Aydin 2 , Abbas Ali Tam 2 , Sevgul Faki 1 , Afra Alkan 3 , Şefika Burçak Polat 2 , Ahmet Dirikoc 2 , Oya Topaloglu 2 , Reyhan Ersoy 2 & Bekir Cakir 2

1Ankara City Hospital, Endocrinology and Metabolism, Turkey; 2Ankara Yildirim Beyazit University, Faculty of Medicine, Endocrinology and Metabolism, Turkey; 3Ankara Yildirim Beyazit University, Faculty of Medicine, Biostatistics, Turkey


It is known that serum thyroglobulin (TG) can increase after fine-needle biopsy of thyroid nodules. We aimed to determine whether TG is increased after ultrasonography guided fine needle capillary biopsy (FNC) of suspicious cervical LNs in thyroidectomized patients and investigate the possible association between change in TG and cytology results.

Material and methods

Data of 188 patients who underwent FNC of suspicious cervical LNs were retrospectively evaluated. Demographical features, radioactive iodine (RAI) treatment status, thyroid-stimulating hormone (TSH), TG, anti-TG antibody and ultrasonography features of LNs were noted. TG levels before FNC (TGb-FNC), after FNC (TGa-FNC), TGa-FNC/TGb-FNC ratio and the number of patients with increased TG were determined. Patients were grouped as benign, nondiagnostic, suspicious for malignancy and malignant according to the cytological results.


The age, gender, clinical diagnosis, history of RAI treatment and TSH levels were similar in different cytological groups. TGa-FNC, <>b-FNC/TGa-FNC, and rate of patients with increased TG were significantly higher in malignant cytology group than other groups (P<0.001)(Table). The optimal cut-off level of TG increase that was predictive for malignancy was 7.6% with a sensitivity of 73.7% and specificity of 85.2%. TG increase was not associated with age, sex, TSH level, antiTG positivity and US features of LNs while signficantly lower in patients who received RAI treatment. Among 31 patients with positive anti-TG, TGb-FNC/TGa-FNC, and rate of patients with increased TG were higher in malignant compared to benign and nondiagnostic cytology groups.

Table. Demographical, clinical and ultrasonography features and thyroglobulin levels in patients with respect to the cytological results of lymph nodes
Characteristics Benign
(n = 124, 66.0%)
(n = 19, 10.1%)
Nondiagnostic (n = 38, 20.2%) Suspicious for malignancy
(n = 7, 3.7%)
TGb-FNC (mcg/l) 0.076 (0.012–0.471)1 1.283 (0.207–7.931)1, 2 0.224 (0.036–1.385)2 0.161 (0.026–0.998) <0.001
TGa-FNC(mcg/l) 0.072 (0.014–0.382)1 2.313 (0.437–12.247)1, 2, 3 0.196 (0.037–1.037)2 0.071 (0.013–0.375)3 <0.001
TGa-FNC/TGb-FNC 1.000 (1.000–1.000)1 1.408 (1.068–1.839)1, 2, 3 1.000 (0.824–1.000)2 0.821 (0.531–1.000)3 <0.001
 Increased TG 18 (14.5)1 14 (73.7)1, 2, 3 7 (18.4)2 0 (0.0)3 <0.001


Serum TG increment and rate of patients with increased TG after FNC of suspicious cervical LNs were higher in patients with malignant cytology than with all other cytology results both in all study group and in sub-group of anti-TG positive patients. Increase in TG after FNC might be an additional tool for determining LN metastasis.

Quantitative and categorical variables are summarized by median (IQR: 25th–75th percentiles) and frequency (%), respectively.

1, 2, 3The same numbers indicates that the corresponding groups are significantly different from each other.

Volume 73

European Congress of Endocrinology 2021

22 May 2021 - 26 May 2021

European Society of Endocrinology 

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