Tireoglobulina no lavado de punção de linfonodos: qual o seu lugar no seguimento do carcinoma diferenciado de tireoide?.

Abstract

Background: The clinical investigation of local enlarged lymph nodes of size at onset or during follow-up of differentiated carcinoma (CDT) is a difficult task. Despite the cytological examination of the material obtained by fine needle aspiration of lymph nodes (FNAC-C) to be extremely specific for the diagnosis of lymph node metastases, its sensitivity is low, especially due to paucicellular samples. Synthesis: Many studies have shown that the determination of thyroglobulin (Tg) in the washing of the needle used in the puncture (FNA-Tg) increases the diagnostic performance of cytology to up to 100% sensitivity and specificity, however this technique is currently limited due to the lack of standardization in its methodology, lack of a point of reference defined cut and the various controversies that still persist about its accuracy in non-thyroidectomized patients with elevated serum Tg or circulating anti-Tg antibodies. Conclusion: PAAF-Tg increases the performance of PAAF-C in determination of lymph node metastases, even when it cannot diagnosing them and therefore should be part of the CDT follow-up.