title: Clinical and imaging assessment of cervical lymph node metastasis in papillary thyroid carcinomas.
abstract: BACKGROUND
  The goals of this study were to analyze clinical factors that affect cervical lymph node metastasis (LNM) in papillary thyroid cancer (PTC), and to evaluate the diagnostic accuracy of preoperative ultrasound (US) and computed tomography (CT) of the neck.
  
  
  METHODS
  The study sample included 589 consecutive patients who underwent surgery for PTC. Patient age and sex, number, size, and location of tumors, lymphovascular invasion, and extrathyroidal extension were evaluated as risk factors for central and lateral LNM.
  
  
  RESULTS
  Increased risk of lymph node metastasis was found for male patients, <45 years old, with tumor size >1 cm, lymphovascular invasion, and extrathyroidal invasion. Cancers located in the upper neck had a higher relative risk of lateral metastasis than cancers located in the lower neck. Sensitivity of both US and CT imaging was higher for lateral (70-80%) than for central (42-47%) LNM. Specificity of US and CT was high (92-97%) for both central and lateral LNM. Using central lymph node size of greater than 5 mm as an indicator of metastasis, preoperative US had 58.3% sensitivity and 71.4% specificity.
  
  
  CONCLUSIONS
  Preoperative US and CT imaging are useful for identifying features that indicate a high risk of LNM and for determining appropriate management of PTC.
authors.affiliation: Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, 110-746, Korea. yoonchoi99@gmail.com
authors.forename: Yoon Jung
authors.initials: YJ
authors.lastname: Choi
authors.forename: Ji Sup
authors.initials: JS
authors.lastname: Yun
authors.forename: Shin Ho
authors.initials: SH
authors.lastname: Kook
authors.forename: Eun Choel
authors.initials: EC
authors.lastname: Jung
authors.forename: Yong Lai
authors.initials: YL
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D009361:Neoplasm Invasiveness; D011859:Radiography; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D014463:Ultrasonography; D055815:Young Adult