The present study was designed to explore the role of ultrasound‑guided fine‑needle aspiration (FNA) cytology combined with thyroid peroxidase antibody (TPO‑Ab) and thyroglobulin antibody (Tg‑Ab) in evaluating cervical lymph node metastasis in thyroid cancer. The aim was to propose more effective diagnostic strategies for cervical lymph node metastasis in patients with thyroid cancer. Firstly, the present retrospective case‑control study selected 294 patients with thyroid cancer treated at Changzhou Second People's Hospital (Changzhou, China). High‑resolution ultrasound equipment was used for ultrasound and FNA examinations. Additionally, a retrospective analysis of the patient's comprehensive thyroid function tests, including TPO-Ab and Tg-Ab levels, was conducted. Subsequently, univariate and multivariate logistic regression models were employed to analyze the association between various factors and cervical lymph node metastasis. The overall diagnostic accuracy of the model was evaluated using the receiver operating characteristic curve and its area under the curve. Finally, the performance of the diagnostic model was quantitatively assessed through calculating sensitivity, specificity, positive predictive and negative predictive values. According to the experimental results, sex, tumor stage and the levels of thyroid autoantibodies were associated with the risk of cervical lymph node metastasis in thyroid cancer. Moreover, ultrasound features, such as cystic lesions, loss of hilum of the lymph nodes, abundant vascular supply, heterogeneous echo and microcalcification were also closely related to cervical lymph node metastasis. Logistic regression analysis also showed that tumor stage, serum levels of TPO‑Ab and Tg‑Ab, and cystic lesions were independent predictors of cervical lymph node metastasis. Furthermore, the combined use of ultrasound, FNA, TPO‑Ab and Tg‑Ab significantly improved diagnostic sensitivity and specificity. Overall, ultrasound‑guided FNA combined with TPO‑Ab and Tg‑Ab may have a significant role in the evaluation of cervical lymph node metastasis in thyroid cancer. This combined diagnostic approach could significantly enhance diagnostic accuracy, providing a more effective strategy for the clinical management of cervical lymph node metastasis in thyroid cancer.

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