Ultrasound-guided fine-needle aspiration biopsy cytology (FNAB-C) is able to detect approximately 63% of medullary thyroid carcinoma (MTC). The measurement of calcitonin in the needle washout (FNAB-CT) could improve its accuracy. Sixty-two FNAB-C were performed in 38 patients. Serum calcitonin (sCT) was measured before performing FNAB-C. After obtaining a FNAB-C specimen, the needle was washed with 0.5 ml of saline solution to obtain the CT washouts. Receiver operating characteristic (RO C) analysis identified the cut-offs of FNAB-CT and FNAB-CT/sCT. Eighteen MTC were found at final histology. RO C analysis indicated FNAB-CT > 10.4 pg/ml and FNABCT/ sCT > 1.39 as more accurate cut-off values. Overall accuracy, positive (PPV) and negative predictive values (NPV) were 85%, 100 and 83%, respectively, for FNAB-C, 97%, 100%, 96% for FNAB-CT and 90%, 83% and 93% for FNAB-CT/sCT. The integration of FNAB-C and FNAB-CT resulted in 98% overall accuracy, 100% PPV and 98% NPV; the integration of FNAB-C and FNAB-CT/sCT in 90% overall accuracy, 80% PPV and 95% NPV. One of 2 false negative FNAB-CT and one of 3 false negative FNAB CT/sCT were correctly diagnosed by FNAB-C. Eight of 9 non-diagnostic FNAB-C were correctly classified by FNAB-CT and 7 by FNAB CT/sCT. FNAB-CT should integrate but not replace FNAB-C. FNAB-CT is particularly useful in the presence of non-diagnostic FNAB-C.

De Crea, C., Raffaelli, M., Maccora, D., Carrozza, C., Canu, G., Fadda, G., Bellantone, R. D. A., Lombardi, C. P., Calcitonin measurement in fine-needle aspirate washouts vs. cytologic examination for diagnosis of primary or metastatic medullary thyroid carcinoma, <<ACTA OTORHINOLARYNGOLOGICA ITALICA>>, 2014; 34 (6): 399-405 [http://hdl.handle.net/10807/66449]

Calcitonin measurement in fine-needle aspirate washouts vs. cytologic examination for diagnosis of primary or metastatic medullary thyroid carcinoma

De Crea, Carmela;Raffaelli, Marco;Maccora, Daria;Carrozza, Cinzia;Canu, Giulia;Fadda, Guido;Bellantone, Rocco Domenico Alfonso;Lombardi, Celestino Pio
2014

Abstract

Ultrasound-guided fine-needle aspiration biopsy cytology (FNAB-C) is able to detect approximately 63% of medullary thyroid carcinoma (MTC). The measurement of calcitonin in the needle washout (FNAB-CT) could improve its accuracy. Sixty-two FNAB-C were performed in 38 patients. Serum calcitonin (sCT) was measured before performing FNAB-C. After obtaining a FNAB-C specimen, the needle was washed with 0.5 ml of saline solution to obtain the CT washouts. Receiver operating characteristic (RO C) analysis identified the cut-offs of FNAB-CT and FNAB-CT/sCT. Eighteen MTC were found at final histology. RO C analysis indicated FNAB-CT > 10.4 pg/ml and FNABCT/ sCT > 1.39 as more accurate cut-off values. Overall accuracy, positive (PPV) and negative predictive values (NPV) were 85%, 100 and 83%, respectively, for FNAB-C, 97%, 100%, 96% for FNAB-CT and 90%, 83% and 93% for FNAB-CT/sCT. The integration of FNAB-C and FNAB-CT resulted in 98% overall accuracy, 100% PPV and 98% NPV; the integration of FNAB-C and FNAB-CT/sCT in 90% overall accuracy, 80% PPV and 95% NPV. One of 2 false negative FNAB-CT and one of 3 false negative FNAB CT/sCT were correctly diagnosed by FNAB-C. Eight of 9 non-diagnostic FNAB-C were correctly classified by FNAB-CT and 7 by FNAB CT/sCT. FNAB-CT should integrate but not replace FNAB-C. FNAB-CT is particularly useful in the presence of non-diagnostic FNAB-C.
Inglese
De Crea, C., Raffaelli, M., Maccora, D., Carrozza, C., Canu, G., Fadda, G., Bellantone, R. D. A., Lombardi, C. P., Calcitonin measurement in fine-needle aspirate washouts vs. cytologic examination for diagnosis of primary or metastatic medullary thyroid carcinoma, <<ACTA OTORHINOLARYNGOLOGICA ITALICA>>, 2014; 34 (6): 399-405 [http://hdl.handle.net/10807/66449]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/66449
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