Cytologic morphometric approach for the prediction of lymph node involvement in papillary thyroid cancer.
OBJECTIVE
Papillary thyroid cancer frequently metastasizes to lymph nodes; however, it is generally difficult to make a precise diagnosis preoperatively. The present study was carried out to evaluate lymph node status preoperatively by using quantitative estimations of various cytologic features obtained by fine needle aspiration biopsy from 110 patients with papillary thyroid cancer.


METHODS
Using a microscope connected to a computerized video system, mean nuclear area (NA) mean circumferential length of nuclei (CL), circular rate (CR), largest to smallest diameter ratio of nuclei (LS), coefficient of variation of NA (NACV), and rates of intranuclear cytoplasmic inclusions (CIs) and nuclear grooves (NG) were calculated and analyzed.


RESULTS
LS, NACV and NG were significantly higher in cases with metastasized lymph nodes than node-negative cases (P < .05, P < .0001, P < .05, respectively). Furthermore, all parameters except CR and LS correlated exactly with the histopathologic features (P < .0001). The number of positive lymph nodes correlated well with the value of NACV, and all cases with recurrences proved to have NACV > 22%.


CONCLUSIONS
Preoperative quantitative estimations of cytologic features are useful parameters for the prediction of lymph node metastases in papillary thyroid cancers.
Nagashima
T
T
First Department of Surgery, Chiba University School of Medicine, Japan.
Suzuki
M
M
Nakajima
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013964:Thyroid Neoplasms / Q000473:pathology*