Thyroid Cancer Clinical Trial
Cytological examination of punctured lymph nodes is the gold standard for confirming
metastatic lymph node spread of differentiated thyroid cancers. In order to increase the
diagnostic sensitivity of fine-needle cyto-punctured lymph nodes, an assessment of Tg levels
of the aspirate could be included. Although this technique has been well proven, many
uncertainties remain, especially with regards to a pathological cut-off value and its
clinical utility when the thyroid is still intact. This uncertainty is mainly due to
discordancy between low Tg levels found in cytopunctured lymph nodes with normal cytology,
and their final histopathological analyses.
To eliminate this uncertainty, cyto-punction will be performed intra-operatively after
localizing and isolating the target lymph nodes for assessment of cytology and Tg values. The
thyroid gland might be present or absent (already operated) depending on the case. Finally,
the cyto-punctured lymph nodes will be excised for complete histopathological analysis. In
order to determine whether the Tg values are appropriate in cases where the thyroid is
intact, a control group has been included (First operation for thyroid cancer or benign
pathology). To eliminate the possible iatrogenic risks of lymph node dissection and resection
in patients for whom it is not indicated, only lymph nodes found along the incision path for
neuromonitoring of the recurrent laryngeal nerve (performed systematically) will be analysed
and excised.
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