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Preoperative ultrasonography and serum thyroid-stimulating hormone on predicting central lymph node metastasis in thyroid nodules as or suspicious for papillary thyroid microcarcinoma

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Tumor Biology

Abstract

The purpose of this study was to describe the ultrasonography (US) image features and preoperative thyroid-stimulating hormone (TSH) level in patients with thyroid nodules read as or suspicious for papillary thyroid microcarcinoma (PTMC) on US-guided fine-needle aspiration biopsy (US-FNAB) and to identify the risk factors for central lymph node metastasis (CLNM) that can guide surgical strategies for patients diagnosed with PTMC on pathology. In this retrospective cross-sectional study, a total of 163 patients diagnosed cytologically and histopathologically were included. Cytological diagnosis for each patient preoperatively was based on the Bethesda classification for the nodule: 44 (27.0 %) were suspicious for papillary carcinoma (Bethesda V) and 119 (73.0 %) were positive for papillary carcinoma (Bethesda VI). PTMC was confirmed in 162 patients on pathology. In the multivariate analysis, the US suspicious images including nodal metastases, microcalcification, and irregular margins, tumor size larger than 7 mm on US, and serum TSH level equal to or greater than 2.5 mIU/L were independent predictors for CLNM in 162 patients diagnosed with PTMC. Prophylactic central lymph node dissection (CLND) may be considered in PTMC patients presenting with risk factors.

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Abbreviations

PTC:

Papillary thyroid cancer

PTMC:

Papillary thyroid microcarcinoma

US:

Ultrasonography

US-FNAB:

US-guided fine-needle aspiration biopsy

TSH:

Thyroid-stimulating hormone

CLNM:

Central lymph node metastasis

LLNM:

Lateral lymph node metastasis

CLND:

Central lymph node dissection

LLND:

Lateral lymph node dissection

OR:

Odds ratio

CI:

Confidence interval

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Acknowledgments

This research is supported by grants from the National Natural Science Foundation of China (81272934) and the Natural Science Foundation of Shanghai (12ZR1406800).

Conflicts of interest

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Authors and Affiliations

  1. Department of Ultrasonography, Fudan University Shanghai Cancer Center, Shanghai, China

    Yi Gao

  2. Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China

    Ning Qu, Ling Zhang, Jia-ying Chen & Qing-hai Ji

  3. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China

    Yi Gao, Ning Qu, Ling Zhang, Jia-ying Chen & Qing-hai Ji

Authors
  1. Yi Gao
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  2. Ning Qu
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  3. Ling Zhang
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  5. Qing-hai Ji
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Corresponding author

Correspondence to Qing-hai Ji.

Additional information

Yi Gao and Ning Qu contribute equally to the paper.

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Gao, Y., Qu, N., Zhang, L. et al. Preoperative ultrasonography and serum thyroid-stimulating hormone on predicting central lymph node metastasis in thyroid nodules as or suspicious for papillary thyroid microcarcinoma. Tumor Biol. 37, 7453–7459 (2016). https://doi.org/10.1007/s13277-015-4535-3

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