scholarly journals Risk factors of the suprasternal lymph node metastasis in papillary thyroid carcinoma with clinical lateral cervical lymph node metastasis

2020 ◽  
Author(s):  
Hyun-Keun Kwon ◽  
Yong-Il Cheon ◽  
Sung-Chan Shin ◽  
Eui-Suk Sung ◽  
Jin-Choon Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Nodal Metastasis ◽  
Papillary Thyroid ◽  
Inferior Pole ◽  
Node Metastasis

Abstract Background: Metastatic lymph nodes are occasionally found in the suprasternal lymph nodes in patients with papillary thyroid cancer (PTC), but there are few studies on these lymph nodes. Therefore, we investigated the frequency and risk factors of suprasternal lymph node metastasis in PTC patients with lateral cervical lymph node metastasis.Methods: A total of 85 patients with cN1b PTC underwent total thyroidectomy with elective lateral neck dissection including the suprasternal lymph nodes. We analyzed the correlation between suprasternal lymph node metastasis and sex, age, tumor characteristics, and cervical lymph node metastasis status.Results: Eleven patients (12.9%) had pathological suprasternal lymph node metastasis. Suprasternal lymph node metastasis was associated with tumors located in the inferior pole and level IV lymph node metastasis.Conclusion: In cN1b PTC patients, especially those with inferior pole tumors and level IV nodal metastasis, the suprasternal lymph node should be routinely dissected.

scholarly journals Prediction of Ipsilateral Lateral Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Combined Dual-energy CT and Thyroid Functional Indicators Study

2020 ◽  
Author(s):  
Ying Zou ◽  
Huanlei Zhang ◽  
Wenfei Li ◽  
Yu Guo ◽  
Fang Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Dual Energy ◽  
Papillary Thyroid ◽  
Node Metastasis

Abstract BackgroundThe prediction of ipsilateral lateral cervical lymph node metastasis (ipsi-LLNM) was crucial to the operation plan in patients with papillary thyroid carcinoma (PTC). This study aimed to investigate the risk factors for ipsi-LLNM using dual-energy computed tomography (DECT) and thyroid functional indicators in patients with PTC. MethodsThe medical records of 406 patients with a pathological diagnosis of PTC were retrospectively reviewed from Jan 2016 to Dec 2019. Demographic, clinical, pathological findings, and parameters from DECT were evaluated. Risk factors for ipsi-LLNM were explored by univariate and multivariate analyses. Receiver operating characteristic (ROC) curves were used to evaluate the cut-off value of each risk factor.ResultsTotally 406 patients with PTC were analyzed, including 128 with ipsi-LLNM and 278 without. There were statistical differences of parameters between the two groups (P < .0001), including serum Tg, Anti-Tg, Anti-TPO, the volume of the primary lesion, calcification, extrathyroidal extension (ETE), and iodine concentration (IC) in arterial and venous phases. Independent risk factors for ipsi-LLNM included serum Tg, Anti-Tg, ETE, and IC in arterial and venous phases (P < .05). Ipsi-LLNM was more likely to occur when the following conditions were met: with ETE, Tg > 100.01 ng/ml, Anti-Tg > 89.43 IU/ml, IC in arterial phase > 3.4 mg/ml and IC in venous phase > 3.1 mg/ml.ConclusionsApplication of DECT parameters and thyroid functional indicators can improve the diagnostic performance in the evaluation of ipsi-LLNM in patients with PTC.

scholarly journals Primary Evaluation of Appling HMGA2 in the Diagnosis of Thyroid Carcinoma

2021 ◽  
Author(s):  
Jian Shen ◽  
Yi Li ◽  
Qiong Wu ◽  
Yilun Liu ◽  
Anqi Jin ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Thyroid Nodules ◽  
Cervical Lymph Node Metastasis ◽  
Expression Level ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Hmga2 Protein

Abstract Background Molecular marker is on the hot spot for thyroid tumor research in the recent years. The purpose of this study is try to clarify the value of HMGA2 for differential diagnosis between benign and malignant thyroid nodules in order to further assessing the risk of simultaneous cervical lymph nodes metastasis. Methods With a total of 125 thyroid samples, including 85 papillary thyroid carcinomas, 20 follicular thyroid adenomas and 20 normal thyroid tissue were retrospectively analyzed, and we compare expression level of HMGA2 protein among these three groups in this study. PTC group was then subdivided according to the number of metastasis lymph nodes in order to explore the possibility of using HMGA2 protein to predict invasion of lymph nodes in PTC. We also compare the efficiency of BRAFV600E mutation and HMGA2 expression level in the prediagnosis of cervical lymph node metastasis during the experiment. Results Expression rate of HMGA2 protein in PTC was measured at 100%, which has significant statistical differences with HMGA2 in FTA and NT (P < 0.05). Moreover, there was no significant correlation between expression level of HMGA2 and the size of PTC; whether it accompanied by Hashimoto's thyroiditis; high expression level of HMGA2 could be more sensitive in the prediagnosis of cervical lymph node metastasis than BRAFV600E mutation. Conclusion ①HMGA2 protein can be used as a molecular marker for differential diagnosis of benign and malignant thyroid nodules. ②The expression level of HMGA2 protein is correlated with cervical lymph node metastasis in papillary thyroid carcinoma, performing an auxiliary value for clinical decision.

UNILATERAL TNM T1 AND T2 PAPILLARY THYROID CARCINOMA WITH LATERAL CERVICAL LYMPH NODE METASTASIS: TOTAL THYROIDECTOMY OR LOBECTOMY?

2020 ◽  
Vol 26 (10) ◽  
pp. 1085-1092
Author(s):  
Zhihong Wang ◽  
Jingzhe Xiang ◽  
Zhiqiang Gui ◽  
Yuan Qin ◽  
Wei Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Papillary Thyroid ◽  
Node Metastasis

Objective: The aim of this study was to explore the effect of total thyroidectomy (TT) and lobectomy (LT) on the prognosis of unilateral papillary thyroid carcinoma (PTC) with lateral cervical lymph node metastasis. Methods: Patients with PTC and lateral cervical lymph node metastasis who underwent lateral cervical lymph node dissection between January 2007 and December 2016 were retrospectively reviewed. To investigate the effect of surgical procedure on the prognosis of lymph node metastasis patients, other high-risk factors such as extrathyroidal invasion and large tumor size were excluded. All patients were in Tumor-Node-Metastasis (TNM) stage T1 and T2. Primary end point was recurrence-free survival (RFS). Results: Among 264 PTC patients, 104 (39.4%) patients received TT and 160 (60.6%) patients received LT. With a median follow-up of 50 months (interquartile range, 34 to 74 months), 7 patients (2.65%) experienced recurrence. The 5-year RFS in the TT and LT groups was 96.1% and 97.7%, respectively, and was not significantly different ( P = .765). Similar results were found when excluding patients who received radioiodine ablation, which were 97.7% and 97.4%, respectively ( P = .752). Age ≥55 years (hazard ratio, 7.368; P = .018) and multifocality in the ispi-lateral lobe (hazard ratio, 10.059; P =.006) were identified as independent risk factors of recurrence. Conclusion: For unilateral TNM T1 and T2 PTC patients with lateral lymph node metastasis, there was no significant difference in the effect of TT and LT for RFS in the absence of other risk factors during the follow-up period. Patient age ≥55 years with multifocality in the unilateral lobe might be independent risk factors for prognosis. Abbreviations: ATA = American Thyroid Association; CT = computed tomography; ETE = extrathyroidal extension; LT = lobectomy; L-T4 = levothyroxine; PTC = papillary thyroid carcinoma; RFS = recurrence-free survival; RIA = radioiodine ablation; TgAb = anti-thyroglobulin antibody; TT = total thyroidectomy; TNM = Tumor-Node-Metastasis

scholarly journals Analysis of the Relevance of the Ultrasonographic Features of Papillary Thyroid Carcinoma and Cervical Lymph Node Metastasis on Conventional and Contrast-Enhanced Ultrasonography

2021 ◽  
Vol 11 ◽  
Author(s):  
Tian Xue ◽  
Chang Liu ◽  
Jing-Jing Liu ◽  
Yan-Hong Hao ◽  
Yan-Ping Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Contrast Enhanced ◽  
The Relationship

BackgroundPreoperative prediction of lymph node metastases has a major impact on prognosis and recurrence for patients with papillary thyroid carcinoma (PTC). Thyroid ultrasonography is the preferred inspection to guide the appropriate diagnostic procedure.PurposeTo investigate the relationship between PTC and cervical lymph node metastasis (CLNM, including central and lateral LNM) using both conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS).Material and MethodsOur study retrospectively analyzed 379 patients diagnosed with PTC confirmed by surgical pathology at our hospital who underwent US and CEUS examinations from October 2016 to March 2021. Individuals were divided into two groups: the lymph node metastasis group and the nonmetastasis group. The relationship between US and CEUS characteristics of PTC and CLNM was analyzed. Univariate and multivariable logistic regression methods were used to identify the high-risk factors and established a nomogram to predict CLNM in PTC. Furthermore, we explore the frequency of CLNM at each nodal level in PTC patients.ResultsUnivariate analysis indicated that there were significant differences in gender, age, tumor size, microcalcification, contact with the adjacent capsule, multifocality, capsule integrity and enhancement patterns in CEUS between the lymph node metastasis group and the nonmetastasis group (all P&lt;0.05). Multivariate regression analysis showed that tumor size ≥1 cm, age ≤45 years, multifocality, and contact range of the adjacent capsule &gt;50% were independent risk factors for CLNM in PTC, which determined the nomogram. The diagnostic model had an area under the curve (AUC) of 0.756 (95% confidence interval, 0.707-0.805). And calibration plot analysis shown that clinical utility of the nomogram. In 162 PTC patients, the metastatic rates of cervical lymph nodes at levels I-VI were 1.9%, 15.4%, 35.2%, 34.6%, 15.4%, 82.1%, and the difference was statistically significant (P&lt;0.001).ConclusionOur study indicated that the characteristics of PTC on ultrasonography and CEUS can be used to predict CLNM as a useful tool. Preoperative analysis of ultrasonographical features has important value for predicting CLNM in PTCs. The risk of CLNM is greater when tumor size ≥1 cm, age ≤45 years, multifocality, contact range of the adjacent capsule &gt;50% are present.

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