scholarly journals Total Tumor Diameter and Unilateral Multifocality as Independent Predictor Factors for Metastatic Papillary Thyroid Microcarcinoma

2021 ◽  
Vol 10 (16) ◽  
pp. 3707
Author(s):  
Liviu Hîțu ◽  
Paul-Andrei Ștefan ◽  
Doina Piciu
Keyword(s):  
Metastatic Disease ◽  
Operating Characteristic ◽  
Independent Predictor ◽  
Tumor Diameter ◽  
Tumor Site ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma ◽  
Therapy Decision ◽  
Metastatic Risk ◽  
Predictor Factors

The purpose of this study was to assess whether total tumor diameter (TTD) and multifocality are predictors for metastatic disease in papillary thyroid microcarcinomas (PTMC). Eighty-two patients with histologically proven PTMC were retrospectively included. Patients were divided according to the presence of metastatic disease in the metastatic (n = 41) and non-metastatic (n = 41) demographic-matched group. The morphological features of PTMCs (primary tumor diameter, multifocality, TTD, number of foci, and tumor site) were compared between groups using univariate, multivariate, and receiver operating characteristic analyses. TTD (p = 0.026), TTD > 10 mm (p = 0.036), and Unilateral Multifocality (UM) (p = 0.019) statistically differed between the groups. The combination of the two independent predictors (TTD and UM) was able to assess metastatic risk with 60.98% sensitivity and 75.61% specificity. TTD and UM can be used to predict metastatic disease in PTMC, which may help to better adapt the RAI therapy decision. We believe that TTD and multifocality are tumor features that should be considered in future guidelines.

Ultrasound grayscale ratio: a reliable parameter for differentiating papillary thyroid microcarcinoma from micronodular goiter

2020 ◽  
Author(s):  
Chenke Xu ◽  
Lifang Yu ◽  
Jianhua Fang ◽  
Zhijiang Han ◽  
Dingcun Luo ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Roc Curves ◽  
Mean Value ◽  
Papillary Thyroid ◽  
Diagnostic Efficacy ◽  
Receiver Operating Characteristic Curves ◽  
Thyroid Microcarcinoma ◽  
Reliable Parameter ◽  
The Mean ◽  
Reading System

Abstract Background: To evaluate the reliability and diagnostic efficacy of the ultrasound grayscale ratio (UGSR) for differentiating papillary thyroid microcarcinomas (PTMC) from micronodular goiters (diameter ≤ 1.0cm).Methods: The ultrasound data of 241 pathologically-confirmed cases of patients with 265 PTMC and 141 patients with 168 micronodular goiters were retrospectively reviewed. All patients underwent outpatient ultrasonic examination and preoperative ultrasonic positioning. The RADinfo radiograph reading system (Zhejiang RAD Information Technology Co., Ltd., China) was used to measure and calculated the UGSR of PTMC, micronodular goiters. Patients were divided into the outpatient examination, preoperative positioning, and mean value groups, and the receiver operating characteristic curves (ROC) were calculated to obtain the optimal UGSR threshold for distinguishing PTMC from micronodular goiters.Results: The UGSR values of the PTMC and micronodular goiters were 0.56±0.14 and 0.80±0.19 (t=5.84, P<0.01) in the outpatient examination group, 0.55±0.14 and 0.80±0.19 (t=18.74, P<0.01) in the preoperative positioning group, and 0.56±0.12 and 0.80±0.18 (t=16.49, P<0.01) in the mean value group. The areas under the ROC curves in the outpatient examination, preoperative positioning, and mean value groups were 0.860, 0.856, and 0.875, respectively. When the cut-off UGSR values for the outpatient examination, preoperative positioning, and mean value groups were 0.649, 0.646, and 0.657, the sensitivity and specificity for predicting PTMC were 78.9% and 86.9%, 79.2% and 83.9%, 82.6%, and 85.7%, respectively. A reliable UGSR value was obtained between the outpatient examination and preoperative positioning groups (ICC=0.79, P=0.68).Conclusion: The UGSR is an accurate and feasible tool for differentiating PTMC from micronodular goiters with better diagnostic efficacy.

scholarly journals Analysis of risk factors for cervical lymph node metastasis of papillary thyroid microcarcinoma: a study of 268 patients

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jian-hua Gu ◽  
Yan-na Zhao ◽  
Rong-li Xie ◽  
Wen-juan Xu ◽  
Da-li You ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Multivariate Regression ◽  
Cervical Lymph Node ◽  
Cervical Lymph Node Metastasis ◽  
Papillary Thyroid Microcarcinoma ◽  
Tumor Diameter ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma ◽  
Male Sex

Abstract Background To investigate the risk factors of cervical lymph node (LN) metastasis in papillary thyroid microcarcinoma (PTMC) patients. Methods We retrospectively analyzed the clinicopathologic data of all patients who received standard lobectomy for PTMC at our institution between October 2017 and January 2019. Central LNs were dissected in all patients. Lateral LNs were dissected if metastasis to the lateral LNs was suggested based on pre-op fine-needle aspiration biopsy. The relationship between variables available prior to surgery and cervical LN metastasis was examined using multivariate regression. Results Post-op pathologic examination revealed cervical LN metastasis in 79 (29.5%) patients. Seventy subjects had metastasis only to central LNs, and 4 (1.5%) patients had metastasis only to lateral LNs. Five patients had metastasis to both central and lateral LNs. In comparison to patients without cervical LN metastasis, those with LN metastasis were significantly younger (40.63 ± 13.07 vs. 44.52 ± 12.23 years; P = 0.021) and had significantly larger tumor diameter on pathology (6.7 ± 2.2 vs. 5.9 ± 2.4 mm; P = 0.010). Multivariate regression analysis identified the following independent risks for cervical LN metastasis: male sex (OR 2.362, 95%CI 1.261~4.425; P = 0.007), age (OR 0.977, 95%CI 0.956~0.999; P = 0.042) and ultrasound tumor diameter at > 5 mm (OR 3.172, 95%CI 1.389~7.240; P = 0.006). Conclusion Cervical LN metastasis occurs in a non-insignificant proportion of PTMC patients. Independent risks included male sex, younger age and larger tumor diameter on ultrasound.

scholarly journals Influencing Factors and Cumulative Risk Analysis of Cervical Lymph Node Metastasis of Papillary Thyroid Microcarcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Yirong Yin ◽  
Xiang Xu ◽  
Liyan Shen ◽  
Wenjuan Zhao ◽  
Hongcui Diao ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Independent Risk Factor ◽  
Cumulative Risk ◽  
Clinicopathological Characteristics ◽  
Tumor Diameter ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Thyroid Microcarcinoma ◽  
Positive Rate

ObjectiveTo explore the influencing factors and cumulative risk of lymph node metastasis (LNM) in papillary thyroid microcarcinoma (PTMC) patients.Methods607 patients confirmed PTMC pathologically after thyroidectomy were enrolled in this retrospective study. The rate of LNM was calculated. Different clinicopathological characteristics were compared in PTMC patients with and without LNM and in different subgroups of LNM, respectively. Correlation between clinicopathological characteristics and LNM was analyzed and the cumulative risk of LNM according to different clinicopathological characteristics was calculated.Results(1) There were 228 cases (37.56%) of PTMC combined with LNM. Compared with the non-lymph node metastasis group, the proportion of age &lt;55 years, male, multiple foci, bilateral foci, diameter&gt;0.5cm, extracapsular invasion, HT and intermediate-to-high risk stratification for recurrence of the LNM group was significantly increased (all p&lt;0.05);(2) Multivariate logistic regression analysis showed that age &lt;55years, male, multiple foci, diameter&gt;0.5cm,HT were independently positively correlated with LNM (all p &lt;0.05); (3) Subgroup analysis showed that women aged &lt;55 years combined with HT and aged≥55 years combined with BMI≥25 kg/m2 were independently positively associated with LNM; (4) With the increase of the tumor diameter, the cumulative risk of LNM in group of age &lt;55 years, males, and multiple foci increased gradually, and was higher than those of age≥55 years, females and single foci, respectively. (5) Among the 228 cases of LNM, the proportion of lymph nodes (LN) &gt;5 and the positive rate of LN were both higher in male group than that in the female group. The proportion of multiple foci and HT in LLNM group was higher than that in CLNM group (all P&lt;0.05).ConclusionAge &lt;55 years, males, multiple foci, diameter &gt;0.5cm and HT were independent risk factors of LNM; HT was an independent risk factor for LNM in female &lt;55 years old, and BMI≥25 kg/m2 was an independent risk factor for LNM in female ≥55 years old; The increase of tumor diameter in age &lt;55 years, males, multiple foci, and bilateral foci increased the cumulative risk of LNM, respectively; The number of LNM and the positive rate of LNM were both higher in male, and patients with multiple foci or HT were more likely to develop into LLNM.

Total tumor diameter: the neglected value in papillary thyroid microcarcinoma

2019 ◽  
Vol 43 (5) ◽  
pp. 601-613 ◽  
Author(s):  
J.-W. Feng ◽  
H. Pan ◽  
L. Wang ◽  
J. Ye ◽  
Y. Jiang ◽  
...  
Keyword(s):  
Papillary Thyroid Microcarcinoma ◽  
Tumor Diameter ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma

MULTIFOCAL PAPILLARY THYROID MICROCARCINOMA WITH A TOTAL TUMOR DIAMETER> 1 CM INDICATE POOR BIOLOGICAL BEHAVIOR? - THE EVIDENCE IS INSUFFICIENT

2020 ◽  
Author(s):  
Bin Zhou ◽  
Lin Wei ◽  
Jianwu Qin
Keyword(s):  
Lymph Node ◽  
Biological Behavior ◽  
Papillary Thyroid Microcarcinoma ◽  
Tumor Diameter ◽  
Capsular Invasion ◽  
Papillary Thyroid ◽  
Central Lymph Node ◽  
Node Metastasis ◽  
Thyroid Microcarcinoma ◽  
Central Lymph

Objective: Multifocal cancer is not uncommon in papillary thyroid microcarcinoma (PTMC) . Our aim was to investigate the correlation between multifocal PTMC, total tumor diameter (TTD) and clinicopathological features. Methods: In total, 206 patients were included and grouped as stage cT1a or cT1b. The primary tumor diameter (PTD) and TTD (the sum of the maximal diameter of each focus) were calculated. These patients were further subgrouped as TTD ≤1 cm or 1 cm<TTD ≤2 cm. The relationships of clinicopathological features between these groups were analyzed. Results: Multifocal cancer was more likely to occur with stage cT1a than stage cT1b (p=0.028). Stage cT1b PTC was more prone to central lymph node metastasis (CLNM) (p=0.001) and capsular invasion (p<0.001) than stage cT1a. There was no difference in clinicopathological factors, such as sex (p=0.448), age (p=0.227), CLNM (p=0.739), number of CLNMs (p=0.142), capsular invasion (p=0.804), BRAF mutation (p=0.905) or recurrence (p=0.789), between the multifocal PTMC and TTD>1 cm and PTD+ TTD≤1 cm groups. For the comparison of stage cT1a and cT1b tumors with a 1 cm<TTD≤2 cm, the multivariate analysis, stage cT1b tumors were more prone to capsular invasion than stage cT1a tumors (p=0.006), with an OR of 19.013 (95% CI: 2.295-157.478), but there was no significant correlation with CLNM. Conclusions: Tumors in stage cT1b are more prone to capsular invasion and CLNM than those in stage cT1a. For multifocal PTMC, calculating the TTD to evaluate adverse biological behavior is insufficient and limited, and further research is needed. Abbreviations: PTC = Papillary thyroid carcinoma; PTMC = Papillary thyroid microcarcinoma ; ETE = Extrathyroidal extension; ATA = American Thyroid Association; CLNM = Central lymph node metastasis; TTD = Total tumor diameter; CLND = Central lymph node dissection; DTC =Differentiated thyroid carcinoma ; US = Ultrasound; CT = Computed tomography; PTD = Primary tumor diameter ; Tg = Thyroglobulin ; Anti-Tg = Anti-thyroglobulin antibody ; FNA = Fine needle aspiration; SD = Standard deviation; OR = Odds ratio; CI = Confidence interval.

scholarly journals Incidence and morphological features of thyroid papillary microcarcinoma in Graves’ disease

2017 ◽  
Vol 145 (9-10) ◽  
pp. 457-462
Author(s):  
Bozidar Kovacevic ◽  
Catarina Eloy ◽  
Jelena Karajovic ◽  
Snezana Kuzmic-Jankovic ◽  
Ivan Soldatovic ◽  
...  
Keyword(s):  
Morphological Characteristics ◽  
Lymphatic Invasion ◽  
Morphological Features ◽  
Biological Behavior ◽  
Graves Disease ◽  
Tumor Diameter ◽  
Papillary Thyroid ◽  
Recurrence Rates ◽  
Thyroid Microcarcinoma ◽  
Wide Range

Introduction/Objective. Association of Graves? disease (GD) and thyroid cancer is reported in a wide range from 0% to 33.7%. Papillary thyroid carcinoma (PTC) is the most commonly diagnosed malignancy in GD, namely its variant ? papillary thyroid microcarcinoma (PTMC). The increasingly frequent PTMC disclose favorable biological behavior with low mortality and recurrence rates. The aim of this work is to report our experience on the frequency and morphological features of PTMC in surgically treated patients with GD. Methods. Over a period of three years, total or near-total thyroidectomy was performed in 129 patients with GD. Results. Incidental PTMC was diagnosed in 24 (18.7%) patients with GD. The mean tumor diameter was 3.03 ? 2.17 mm. The average age of patients in the GD with PTMC group was 48.50 ? 13.07 years, while in the GD without PTMC group it was 41 ? 13.12 years, and it proved to be statistically significant ( p = 0.045). Most of the PTMC were unifocal (83%), and the most common morphological features of PTMC were intraparenchymal localization (62.5%), follicular morphology (66.7%), and infiltrative growth pattern (62.5%). Extrathyroidal extension, lymphatic invasion and multifocality of PTMC were more commonly related with subcapsular localized PTMC. The presence of at least one nodule in the GD with PTMC group was 58.3%, while in the GD without PTMC group it was 26.7%, and it was statistically significant (p = 0.003). Conclusion. Our results showed a high incidence of PTMC (18.7%) in patients with GD. Clinically, the most important morphological characteristics of PTMC were related with its subcapsular localization.

Clinical Characteristics of Papillary Thyroid Microcarcinoma

2010 ◽  
Vol 53 (3) ◽  
pp. 166 ◽  
Author(s):  
Jae Won Kim ◽  
Dong Youl Lee ◽  
Young Up Cho ◽  
Chang Hyo Kim ◽  
Yoon Suk Oh ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma
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