scholarly journals Clinical Analysis of Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 3686 Patients

2020 ◽  
Vol Volume 12 ◽  
pp. 2523-2530 ◽  
Author(s):  
Jianlu Song ◽  
Ting Yan ◽  
Wangwang Qiu ◽  
Youben Fan ◽  
Zhili Yang
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Retrospective Study ◽  
Lymph Node Metastasis ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Clinical Analysis ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Thyroid Microcarcinoma

scholarly journals Prediction of Ipsilateral Lateral Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Combined Dual-energy CT and Thyroid Functional Indicators Study

2020 ◽  
Author(s):  
Ying Zou ◽  
Huanlei Zhang ◽  
Wenfei Li ◽  
Yu Guo ◽  
Fang Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Dual Energy ◽  
Papillary Thyroid ◽  
Node Metastasis

Abstract BackgroundThe prediction of ipsilateral lateral cervical lymph node metastasis (ipsi-LLNM) was crucial to the operation plan in patients with papillary thyroid carcinoma (PTC). This study aimed to investigate the risk factors for ipsi-LLNM using dual-energy computed tomography (DECT) and thyroid functional indicators in patients with PTC. MethodsThe medical records of 406 patients with a pathological diagnosis of PTC were retrospectively reviewed from Jan 2016 to Dec 2019. Demographic, clinical, pathological findings, and parameters from DECT were evaluated. Risk factors for ipsi-LLNM were explored by univariate and multivariate analyses. Receiver operating characteristic (ROC) curves were used to evaluate the cut-off value of each risk factor.ResultsTotally 406 patients with PTC were analyzed, including 128 with ipsi-LLNM and 278 without. There were statistical differences of parameters between the two groups (P < .0001), including serum Tg, Anti-Tg, Anti-TPO, the volume of the primary lesion, calcification, extrathyroidal extension (ETE), and iodine concentration (IC) in arterial and venous phases. Independent risk factors for ipsi-LLNM included serum Tg, Anti-Tg, ETE, and IC in arterial and venous phases (P < .05). Ipsi-LLNM was more likely to occur when the following conditions were met: with ETE, Tg > 100.01 ng/ml, Anti-Tg > 89.43 IU/ml, IC in arterial phase > 3.4 mg/ml and IC in venous phase > 3.1 mg/ml.ConclusionsApplication of DECT parameters and thyroid functional indicators can improve the diagnostic performance in the evaluation of ipsi-LLNM in patients with PTC.

scholarly journals Nomogram for Preoperative Estimation of Cervical Lymph Node Metastasis Risk in Papillary Thyroid Microcarcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Jinxiao Sun ◽  
Qi Jiang ◽  
Xian Wang ◽  
Wenhua Liu ◽  
Xin Wang
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Clinical Findings ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Internal Validation ◽  
Node Metastasis ◽  
Thyroid Microcarcinoma

ObjectiveAccurate preoperative identification of cervical lymph node metastasis (CLNM) is essential for clinical management and established of different surgical protocol for patients with papillary thyroid microcarcinoma (PTMC). Herein, we aimed to develop an ultrasound (US) features and clinical characteristics-based nomogram for preoperative diagnosis of CLNM for PTMC.MethodOur study included 552 patients who were pathologically diagnosed with PTMC between January 2015 and June 2019. All patients underwent total thyroidectomy or lobectomy and divided into two groups: CLNM and non-CLNM. Univariate and multivariate analysis were performed to examine risk factors associated with CLNM. A nomogram comprising the prognostic model to predict the CLNM was established, and internal validation in the cohort was performed.ResultsCLNM and non-CLNM were observed in 216(39.1%) and 336(60.9%) cases, respectively. Seven variables of clinical and US features as potential predictors including male sex (odd ratio [OR] = 1.974, 95% confidence interval [CI], 1.243-2.774; P =0.004), age &lt; 45 years (OR = 4.621, 95% CI, 2.160-9.347; P &lt; 0.001), US-reported CLN status (OR = 1.894, 95% CI, 0.754-3.347; P =0.005), multifocality (OR = 1.793, 95% CI, 0.774-2.649; P =0.007), tumor size ≥ 0.6cm (OR = 1.731, 95% CI,0.793-3.852; P =0.018), ETE (OR = 3.772, 95% CI, 1.752-8.441;P&lt; 0.001) and microcalcification (OR = 2.316, 95% CI, 1.099-4.964; P &lt; 0.001) were taken into account. The predictive nomogram was established by involving all the factors above used for preoperative prediction of CLNM in patients with PTCM. The nomogram model showed an AUC of 0.839 and an accuracy of 77.9% in predicting CLNM. Furthermore, the calibration curve demonstrated a strong consistency between nomogram and clinical findings in prediction CLNM for PTMC.ConclusionsThe nomogram achieved promising results for predicting preoperative CLNM in PTMC by combining clinical and US risk factor. Our proposed prediction model is able to help determine an individual’s risk of CLNM in PTMC, thus facilitate reasonable therapy decision making.

scholarly journals Risk factors of the suprasternal lymph node metastasis in papillary thyroid carcinoma with clinical lateral cervical lymph node metastasis

2020 ◽  
Author(s):  
Hyun-Keun Kwon ◽  
Yong-Il Cheon ◽  
Sung-Chan Shin ◽  
Eui-Suk Sung ◽  
Jin-Choon Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Nodal Metastasis ◽  
Papillary Thyroid ◽  
Inferior Pole ◽  
Node Metastasis

Abstract Background: Metastatic lymph nodes are occasionally found in the suprasternal lymph nodes in patients with papillary thyroid cancer (PTC), but there are few studies on these lymph nodes. Therefore, we investigated the frequency and risk factors of suprasternal lymph node metastasis in PTC patients with lateral cervical lymph node metastasis.Methods: A total of 85 patients with cN1b PTC underwent total thyroidectomy with elective lateral neck dissection including the suprasternal lymph nodes. We analyzed the correlation between suprasternal lymph node metastasis and sex, age, tumor characteristics, and cervical lymph node metastasis status.Results: Eleven patients (12.9%) had pathological suprasternal lymph node metastasis. Suprasternal lymph node metastasis was associated with tumors located in the inferior pole and level IV lymph node metastasis.Conclusion: In cN1b PTC patients, especially those with inferior pole tumors and level IV nodal metastasis, the suprasternal lymph node should be routinely dissected.

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