[Role of preoperative ultrasonography in evaluating early cervical metastasis in patients with differentiated thyroid carcinoma].
OBJECTIVE
To evaluate the role of preoperative ultrasonography in detecting early cervical lymph node metastasis in differentiated thyroid carcinoma.


METHODS
Data were reviewed retrospectively from medical records between July 2003 and July 2005, in which patients were divided into 2 groups: group A (study group): 51 (55 sides) patients of differentiated thyroid carcinoma patients with impalpable node but with ultrasonic positive nodal metastasis; group B (control group): 57 (64 sides) patients with preoperative palpable cervical lymph nodes. All patients had been undergone modified neck dissection. The preoperative ultrasonographic results and the preoperative pathologic finding had been compared in group A.


RESULTS
In 51 patients (55 sides of preoperative positive ultrasonography 49 sides had been demonstrated cervical lymph nodes metastasis pathologically. The sensitivity of ultrasonography was 89.1%. Ultrasonography detected cervical lymph node believed to be uninvolved by physical examination in 41.2% of patients. 65.5% of the cervical lymph metastasis was multilevel and the most frequent involvement site was middle neck and the involvement rate was 70.9% in ultrasonography. 75.5% of the cervical lymph metastasis was multilevel and the most frequent involvement site was level Ill (65.3%) in pathologic finding.


CONCLUSIONS
Preoperative ultrasonograpy is a mainstay in detecting cervical lymph nodes metastasis in thyroid cancer patients. It can detect the early cervical lymph node metastasis and localize the position of the cervical metastasis. All the thyroid cancer patients should undergo preoperative ultrasonography and the extent of the neck dissection relies on the preoperative ultrasonic finding of the neck.
Bian
Xue
X
Department of Head and Neck Surgery, Cancer Hospital, CAMS and PUMC, Beijing 100021, China. Bianxue1020@sina.com
Tang
Ping-Zhang
PZ
Xu
Zhen-Gang
ZG
Wen
Shu-Xin
SX
Wang
Jian-Hong
JH
D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000556:secondary*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D011300:Preoperative Care; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography