BACKGROUND: Lymph node metastasis (LNM) characterized by high thyroglobulin measurement through fine-needle aspiration (FNA-Tg) is correlated with elevated tumor burden in papillary thyroid carcinoma (PTC). However, the prognostic significance of FNA-Tg remains incompletely understood. The aim of this study was to determine the prognostic significance of FNA-Tg for stratification of patients at high risk of local recurrence following therapeutic lateral neck dissection (LND) in PTC. PATIENTS AND METHODS: This study reviewed medical records of PTC patients with suspected lateral LNM, who underwent FNA-Tg and therapeutic LND. Logistic regression analyses were used to assess the relationships between clinical outcomes and FNA-Tg in lateral LNM. The prognostic value was evaluated using Cox regression and Kaplan-Meier survival curve analyses. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off values. RESULTS: The median FNA-Tg levels of metastatic LNs were 500.00 ng/mL and 328.40 ng/mL in patients with and without recurrence, respectively. Multivariate analysis revealed that FNA-Tg > 397.00 ng/mL, multifocality, and lateral lymph nodes ratio (LLNR) > 0.161 as independent risk factors for local recurrence or persistence (p < 0.05). Notably, an FNA-Tg cut-off value of 397.00 ng/mL combined with multifocality and LLNR had a higher predictive value with an area under the ROC curve of 0.912. Additionally, all the three factors were associated with shorter recurrence-free survival (p < 0.05). CONCLUSION: As an independent preoperative risk factor for predicting local recurrence or persistence, FNA-Tg assisted in guiding the extent of therapeutic LND and identifying patients at high-risk of postoperative recurrence.
Yang et al. (2026) studied this question.