Exploration of the clinical significance of rapid intraoperative measurement of lymph node thyroglobulin concentration in determining lymph node metastasis of papillary thyroid carcinoma
Abstract
Objective: This study aims to evaluate the diagnostic accuracy of thyroid globulin (Tg) detection in elution fluid for intraoperative judgment of lymph node metastasis, and to explore the potential role of biomolecular mechanical behavior in influencing the detection results. By rapidly quantifying Tg levels, the optimal cutoff value was determined, and its potential value in clinical applications was further assessed. Methods: This is a prospective study that included 65 patients with papillary thyroid carcinoma who underwent surgery at Xiangyang Central Hospital's thyroid surgery department from November 2022 to May 2023. A total of 150 cervical lymph node samples were collected. Tg levels were detected intraoperatively using colloidal gold immunochromatographic assay (FNA-TG-GICA), and results were compared with routine paraffin pathology findings. Particular attention was given to the reactivity of Tg molecules in the elution fluid. The optimal cutoff value for Tg test to judge the benign or malignant nature of lymph nodes was determined by plotting the ROC curve and calculating the AUC, to evaluate the diagnostic performance of the intraoperative Tg detection in identifying lymph node metastasis. Results: A total of 150 lymph node samples were included in this study, of which paraffin pathology verification showed 50 metastatic and 100 non-metastatic lymph nodes. The optimal cutoff value for Tg test was 77 ng/mL, with sensitivity of 94.00%, specificity of 96%, and accuracy of 95%. The AUC from the ROC curve analysis was 0.97, indicating high diagnostic accuracy. Further analysis revealed that most of the positive samples were metastatic lymph nodes, and all negative samples were non-metastatic, suggesting that the Tg test performs excellently in determining lymph node metastasis. Conclusion: Elution fluid Tg test demonstrates high accuracy in intraoperatively determining lymph node metastasis. With an optimal cutoff value of 77 ng/mL, it shows excellent sensitivity and specificity. This detection method serves as a rapid and reliable diagnostic tool, providing effective decision support for clinical practice.
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