Eleonora Fois
The usefulness of calcitonin assay in fine needle aspiration biopsy (FNAB) fluid of neck masses of patients with primitive and metastatic medullary thyroid carcinoma (MTC).
F. Boi;I. Maurelli;F. Atzeni;M. Piga;S. Mariotti
2007-01-01
Abstract
Objective: To evaluate the usefulness of calcitonin (CT) assay in fine needle aspiration biopsy (CT-FNAB) wash-out fluid alone or combined to cytology in the pre-surgical study of medullary thyroid carcinoma (MTC) patients with thyroid nodules and of suspicious neck MTC recurrences/metastases. Subjects and methods: Thirthy-six ultrasound (US)-guided FNAB were performed in neck masses from 23 patients with borderline or high basal and pentagastrin (PG) stimulated serum CT. Cytology and CT-FNAB were performed on a total of 18 thyroid nodules (TN) and 3 neck lymph nodes (LN) from 12 patients examined before thyroidectomy and on 6 suspicious local recurrences (LR) and 9 LN from 9 totally thyroidectomized MTC patients. On the basis of CT-FNAB values found in 15 non-MTC lesions, CT-FNAB >36 pg/ml was considered as indicative of MTC. Results: All the 21 positive CT-FNAB lesions (10 TN, 6 LN and 5 LR), 13 with positive cytology, were confirmed as MTC at histology. Among the 15 negative CT-FNAB suspicious masses (8 TN, 6 LN and 1 LR) 5 displayed a benign lesion at histology. The remaining 10 cases, all with benign cytology, were not operated and no evidence of MTC has been detected at follow-up. CT-FNAB reached 100% of sensitivity and specificity for MTC, while cytology displayed 61.9% of sensitivity and 80% of specificity when calculated in the operated lesions. Conclusions: US-guided CT-FNAB resulted the best tool to identify primary MTC and local recurrences/node metastases in MTC operated subjects with much more sensitivity and specificity than cytology. This may have important implications in the management of MTC patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.