Predicting the factors of lateral lymph node metastasis in papillary microcarcinoma of the thyroid in eastern China
- 345 Downloads
Lateral lymph node metastasis is common in papillary thyroid microcarcinoma (PTMC). The present study evaluated the clinicopathologic characteristics and ultrasonographic (US) findings in predicting lateral LNM from PTMC in eastern China.
Materials and methods
A total of 176 patients with confirmed PTMC by final histological examination who underwent central lymph node dissection (LND) and lateral LND were enrolled in our study. The clinicopathological and US data from the cases were analyzed retrospectively to determine the independent predictive factors for lateral LNM. Then, a scoring system was developed on the basis of independent factors. The sum of the points for individuals was evaluated for the value in predicting lateral LNM.
Central LNM, underlying Hashimoto’s thyroiditis, upper pole location, no well-defined margin and presence of calcifications were independent predictive factors for lateral LNM on multivariate analysis. Clinicopathological and US index points were statistically significant, with ≤2 favoring lateral LNM negativity with a sensitivity of 83.3 %, positive predictive value of 89.6 % and negative predictive value of 72.9 %.
When the evaluation for lateral lymph nodes from a preoperative approach is inadequate or not obvious, our scoring system for prediction of lateral LNM can be another choice. Patients with clinicopathological and US index points ≤2 could be considered as lateral LNM negative, so more diagnostic approach is recommended for patients with clinicopathological and US index points >2.
KeywordsThyroid neoplasms Papillary thyroid microcarcinoma Ultrasonographic Lateral lymph node metastasis
Lymph node metastasis
Papillary thyroid microcarcinoma
Papillary thyroid carcinoma
- ROC curves
Receiver-operating characteristic curves
Fine-needle aspiration cytology
Lymph node dissection
Conflict of interest
There is no financial relationship that might lead to a conflict of interest in relation to the manuscript.
- 5.Wang Y, Ji M, Wang W, Miao Z, Hou P, Chen X, Xu F, Zhu G, Sun X, Li Y et al (2008) Association of the T1799A BRAF mutation with tumor extrathyroidal invasion, higher peripheral platelet counts, and over-expression of platelet-derived growth factor-B in papillary thyroid cancer. Endocr Relat Cancer 15:183–190PubMedCrossRefGoogle Scholar
- 9.Sherman SI, Brierley JD, Sperling M, Ain KB, Bigos ST, Cooper DS, Haugen BR, Ho M, Klein I, Ladenson PW et al (1998) Prospective multicenter study of thyroid carcinoma treatment: initial analysis of staging and outcome. National Thyroid Cancer Treatment Cooperative Study Registry Group. Cancer 83:1012–1021PubMedCrossRefGoogle Scholar
- 11.Ito Y, Higashiyama T, Takamura Y, Miya A, Kobayashi K, Matsuzuka F, Kuma K, Miyauchi A (2007) Risk factors for recurrence to the lymph node in papillary thyroid carcinoma patients without preoperatively detectable lateral node metastasis: validity of prophylactic modified radical neck dissection. World J Surg 31:2085–2091PubMedCrossRefGoogle Scholar
- 27.Takamura Y, Miya A, Kobayashi K, Matsuzuka F, Kuma K, Miyauchi A, Tomoda C, Ito Y, Uruno T (2004) Preoperative Ultrasonographic Examination for Lymph Node Metastasis: usefulness when Designing Lymph Node Dissection for Papillary Microcarcinoma of the Thyroid. World J Surg 28:498–501PubMedCrossRefGoogle Scholar
- 29.Ito Y, Tomoda C, Uruno T, Takamura Y, Miya A, Kobayashi K, Matsuzuka F, Kuma K, Miyauchi A (2005) Ultrasonographically and anatomopathologically detectable node metastases in the lateral compartment as indicators of worse relapse-free survival in patients with papillary thyroid carcinoma. World J Surg 29:917–920PubMedCrossRefGoogle Scholar