Elevated thyroglobulin levels in fine-needle aspiration washout fluid from thyroid nodules: a potential marker of benign nature?

INTRODUCTION: To investigate the relationship between thyroglobulin (Tg) levels obtained from thyroid fine-needle aspiration (FNA) and cytopathological results. MATERIAL AND METHODS: This cross-sectional study included patients who underwent FNA between January 2023 and August 2024 in accordance wit...

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Main Authors: Serhat Uysal, Cem Sulu, Banu Betul Kocaman, Ilkin Muradov, Lala Soltanova, Serdar Sahin, Hande Mefkure Ozkaya, Dildar Konukoglu, Taner Damci, Mustafa Sait Gonen
Format: Article
Language:English
Published: Via Medica 2025-08-01
Series:Endokrynologia Polska
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Online Access:https://journals.viamedica.pl/endokrynologia_polska/article/view/105584
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Summary:INTRODUCTION: To investigate the relationship between thyroglobulin (Tg) levels obtained from thyroid fine-needle aspiration (FNA) and cytopathological results. MATERIAL AND METHODS: This cross-sectional study included patients who underwent FNA between January 2023 and August 2024 in accordance with the American College of Radiology Thyroid Imaging Reporting and Data System risk scoring. Patients with pure cystic nodules, non-thyroid malignancy, and major psychiatric disorders that could interfere with compliance during the procedure were excluded from the study. FNA-Tg samples were obtained from the nodules using a 22-gauge needle on the first attempt. FNA-Tg levels were then measured by electrochemiluminescence immunoassay. These levels were compared among different patient groups and classified according to the cytopathological examination results based on the Bethesda System for Reporting Thyroid Cytopathology. Statistical analyses were performed using the Statistical Package for the Social Sciences, version 20. RESULTS: The study included 193 FNA samples in 193 patients. In 148 (76.7%) out of 193 samples the aspirate was diagnostic. Of these, 101 (68.2%) were benign (Bethesda II), 29 (19.6%) were indeterminate (Bethesda III–IV), and 18 (12.2%) were malignant (Bethesda V–VI). FNA-Tg levels were significantly higher in benign nodules compared to malignant ones (p < 0.001). There was no significant difference between concomitant serum Tg levels in patients with benign and malignant nodules (p = 0.614). An FNA-Tg value above 13,262 ng/mL predicted benign cytology with 71.3% sensitivity and 77.8% specificity. CONCLUSIONS: FNA-Tg levels may provide valuable insights into FNA cytology and serve as an effective marker for distinguishing benign nodules from those with malignant characteristics.
ISSN:0423-104X
2299-8306