| Abstract [eng] |
Aim. To evaluate the diagnostic value of thyroglobulin measurement in fine-needle aspiration aspirates for detecting cervical lymph node metastases of thyroid carcinoma. Methods. A systematic literature review was performed according to the PRISMA guidelines. The literature search was conducted in the PubMed database. full-text articles published in English between 2015 and 2025 were included if they investigated an adult population and assessed the diagnostic value of thyroglobulin measurement in fine-needle aspiration aspirates for detecting cervical lymph node metastases of thyroid carcinoma. A total of 26 studies were included in the final analysis. Data were analysed descriptively, and the studies were grouped according to the clinical setting: patients before thyroidectomy, patients after thyroidectomy and mixed patient groups. Additionally, two clinical cases are presented, illustrating the diagnostic significance of this test before and after thyroidectomy. Results. The analysed studies showed that thyroglobulin measurement in fine-needle aspiration aspirates had high diagnostic sensitivity and specificity. Before thyroidectomy, sensitivity ranged from 80.77 % to 100 %, and specificity ranged from 66.7 % to 100 %. After thyroidectomy, sensitivity ranged from 88.5 % to 100 %, and specificity ranged from 80 % to 100 %. In mixed patient groups, sensitivity ranged from 84.5 % to 97.5 %, and specificity ranged from 75 % to 100 %. The highest diagnostic accuracy was observed in patients after thyroidectomy. The proposed diagnostic cut-off values varied considerably between studies: from 1.0 to 227.1 ng/mL in the preoperative group, from 0.7 to 28.3 ng/mL in the postoperative group and from 0.236 to 229.1 ng/mL in mixed patient groups. The lowest variability in cut-off values was observed in patients after thyroidectomy, whereas the greatest variability was found in mixed patient groups. Conclusions. Thyroglobulin measurement in fine-needle aspiration aspirates is a clinically significant, sensitive and specific additional method for detecting cervical lymph node metastases of thyroid carcinoma. The highest diagnostic value of this method was observed in patients after thyroidectomy, in whom the interpretation of results was more consistent and the variability of cut-off values was lower. In preoperative and mixed patient groups, interpretation is more complex because of the presence of residual thyroid tissue and greater heterogeneity of diagnostic parameters. The clinical cases confirm that thyroglobulin measurement in fine-needle aspiration aspirates can be a significant diagnostic marker in cases where the cytological findings are benign or non-diagnostic. In clinical practice, this method should be used as an adjunct to cytological examination, and its results should be interpreted in the context of the overall clinical picture and the patient’s surgical status. |
