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Statement of interest: None

FNA-TG of Neck Nodes i n the Patients with PTC is Affected by Serum Concentration of TSH And Thyroglobulin. JH Moon 1 , YI Kim 2 , JA Lim 3 , HS Choi 3 , SW Cho 3 , KW Kim 4 , JC Paeng 2 , YJ Park 3 , KH Yi 5 , DJ Park 3 , J-K Chung 2

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Statement of interest: None

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  1. FNA-TG of Neck Nodes in the Patients with PTC is Affected by Serum Concentration of TSH And Thyroglobulin JH Moon1, YI Kim2, JA Lim3, HS Choi3, SW Cho3, KW Kim4, JC Paeng2, YJ Park3, KH Yi5, DJ Park3, J-K Chung2 1Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine 2Department of Nuclear Medicine, Seoul National University College of Medicine 3Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine 4Seoul National University Healthcare System Kangnam Center, Seoul National University College of Medicine 5SMG-SNU Boramae Medical Center, Seoul National University College of Medicine

  2. Statement of interest: None

  3. FNA-Tg • Measuring the concentration of thyroglobulin directly in the washout of the needle used in FNAC Various cut-off value (0.93-50 ng/ml) • Factors affecting FNA-Tg and resulting in the discrepancy between the final diagnosis and FNA-Tg

  4. Study objectives • To suggest an optimal cut-off value of FNA-Tg to determine malignant LN with a large number of cases from PTC patients • To find out parameters affecting FNA-Tg and the diagnosis using FNA-Tg - Evaluation of discrepant results

  5. Subjects and Methods

  6. Patient characteristics and FNA-Tg according to the final diagnosis

  7. Validation of Cut-off value (FNA-Tg vs. FNA-Tg – serum Tg)

  8. Diagnostic performance ROC of FNA-Tg for Dx of malig. LN. in all cases Optimal cut-off value: 1.0 ng/ml AUC: 0.967 (95% CI 0.949-0.984)

  9. The cut-off value of FNA-Tg according to the presence of thyroid gland Prior to thyroidectomy After thyroidectomy 2.24 ng/ml (95.0%, 96.3%) AUC: 0.987 (95% CI 0.975-0.999) 1.09 ng/ml (90.8%, 96.5%) AUC: 0.956 (95% CI 0.932-0.980)

  10. FNA-Tg, serum Tg and TSH according to the presence of thyroid gland FNA-Tg 201.0 (3884.77) 0.1 (2.90)

  11. Correlation of FNA-Tg with serum Tg or TSH

  12. Correlation of FNA-Tg with TgAb 0.3 (71.46) 0.1 (7.15) TgAb - TgAb +

  13. Serum TSH and Tg on the diagnosis from FNA-Tg Logistic regression analysis of serum TSH and Tg with the diagnosis using FNA-Tg cut-off value 1.0 ng/ml Logistic regression analysis of serum TSH suppression and serum Tg presence with the diagnosis using FNA-Tg cut-off value 1.0 ng/ml

  14. Clinical implications

  15. Summary • Optimal cut-off value of FNA-Tg was 1.0 ng/ml • FNA-Tg + FNAC showed better diagnostic rate than FNAC or FNA-Tg alone. • FNA-Tg was correlated with serum Tg and TSH, not with TgAb. • The diagnosis using FNA-Tg can be affected by serum TSH and Tg levels.

  16. Conclusion • The combination of FNAC and FNA-Tg can complement the low sensitivity of FNAC alone. • TSH suppression and the presence of serum Tg should be considered for accurate FNA-Tg-based diagnosis of metastatic malignant LNs in PTC patients.

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