title: Clinical and sonographic assessment of cervical lymph node metastasis in papillary thyroid carcinoma.
abstract: The purpose of this study was to assess the differences in clinical and sonographic features of papillary thyroid carcinoma (PTC) between cervical lymph node metastatic (CLNM) and nonmetastatic groups. Clinical data of PTC patients (414 patients with 624 malignant nodules) who underwent a preoperative ultrasonography and surgery between June 2010 and March 2015 at Renmin Hospital of Wuhan University were retrospectively analyzed. Clinical factors, preoperative ultrasound features and the final pathological findings were obtained. The differences in the sonographic features of PTC between the CLNM group and the non-CLNM group were analyzed. There were 187 CLNM and 227 non-CLNM patients. The median age at the diagnosis of this cohort was 45.4 years old (ranging from 18 to 77 years). Ultrasonographic parameters that were significantly associated with CLNM [OR=2.569 (1.502, 4.393), P<0.001)] were as follows: the mulifocality of the nodules, size over 2 cm, the presence of microcalcifications, the distance ratio (DR) pattern showing the contact of the nodules with the thyroid capsule, and the extracapsular spread of the nodules. No significant differences in age, gender, thyroid stimulating hormone (TSH) levels and other ultrasonography parameters were found between the CLNM and the non-CLNM groups. Therefore, our results suggest that a larger size, microcalcifications, mulifocality, and the DR pattern showing the contact of the nodules with the thyroid capsule and extracapsular spread are significantly more indicative of CLNM in PTC.
authors.affiliation: Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Zhang
authors.affiliation: Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
authors.forename: Si
authors.initials: S
authors.lastname: Sun
authors.affiliation: Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
authors.forename: Juan-Juan
authors.initials: JJ
authors.lastname: Li
authors.affiliation: Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Breast Surgery, Hubei Cancer Hospital, Wuhan, 430079, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Zhu
authors.affiliation: Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Wei
authors.affiliation: Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China. sun137@sina.com.
authors.forename: Sheng-Rong
authors.initials: SR
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging* / Q000473:pathology; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
keywords: cervical lymph node metastasis; clinical and sonographic assessment; papillary thyroid carcinoma