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Abstract：
Cervical lymph node (LN) metastasis is common in differentiated thyroid cancer (DTC). This study evaluated the utility of the washout CYFRA 21-1 level, combined with the thyroglobulin (Tg) concentration, in terms of diagnosis of LN metastasis. We prospectively enrolled 53 patients who underwent thyroid surgery to treat DTC with lateral cervical LN metastases. Preoperative ultrasound guided needle localization was used to surgical sampling of specific LNs during the operation. The intraoperative washout Tg and CYFRA 21-1 levels were measured in such LNs. The Tg and CYFRA 21-1 levels differed significantly between metastatic and benign LNs. The cutoff values were 2.63 ng/mL for washout CYFRA 21-1 and 22.62 ng/mL for Tg. Combined use of the washout Tg and CYFRA 21-1 levels afforded the highest diagnostic accuracy (92.5%), better than that of individual markers. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were 94.6%, 90.0%, 91.4%, 93.8%, respectively. The conjunction of the washout CYFRA21-1 and Tg levels enhances the diagnostic accuracy of LN metastasis in DTC patients. The washout CYFRA 21-1 level may be useful when malignancy is suspected, especially in cases where the cytology and washout Tg findings do not provide definitive results.
摘要：
颈淋巴结（LN）转移在分化型甲状腺癌（DTC）中很常见。这项研究评估了冲洗CYFRA21-1水平的效用，结合甲状腺球蛋白（Tg）浓度，在诊断LN转移方面。我们前瞻性招募了53例接受甲状腺手术治疗DTC伴宫颈外侧LN转移的患者。术前超声引导下的针定位用于术中特定LN的手术采样。在此类LN中测量术中冲洗Tg和CYFRA21-1水平。转移性和良性LN之间的Tg和CYFRA21-1水平显着不同。对于冲洗CYFRA21-1,截断值为2.63ng/mL,对于Tg,截断值为22.62ng/mL。结合使用冲洗Tg和CYFRA21-1水平可提供最高的诊断准确性（92.5％），比单个标记更好。敏感性,特异性，阳性预测值(PPV)，阴性预测值（NPV）为94.6%，90.0%,91.4%,93.8%,分别。冲洗CYFRA21-1和Tg水平的结合提高了DTC患者中LN转移的诊断准确性。当怀疑是恶性肿瘤时，清除CYFRA21-1水平可能是有用的，特别是在细胞学和冲洗Tg结果不能提供明确结果的情况下。
