Correlation Between Ultrasonic Features Of Thyroid Carcinoma And Cervical Lymph Node Metastasis

Objective:The aim of this study was to investigate the factors that affect cervical lymph node metastasis(CLNM)in patients with medullary thyroid carcinoma(MTC)、papillary thyroid carcinoma(PTC)in terms of ultrasonic characteristics and other parameters.Methods:1.A retrospective analysis was performed on eighty-five MTC patients who underwent the first surgical treatment from April 2009 to December 2018 at the Zhejiang Cancer Hospital.Grouping method 1:Divided into CLNM group and non CLNM group according to postoperative pathological results;Grouping method 2:Divided into central area CLNM group and non-central area CLNM group according to postoperative pathological results group.Ultrasonic characteristics of thyroid tumor,preoperative calcitonin levels and general information were recorded in the two groups of patients to perform univariate and multivariate analysis which evaluate the factors that influence CLNM and central area CLNM in MTC patients.2.A retrospective analysis was performed on three hundred seventy-nine PTC patients who underwent the first surgical treatment from January 2018 to December 2018 at the Zhejiang Cancer Hospital.Grouping method 1:Divided into CLNM group and non CLNM group according to postoperative pathological results;Grouping method 2:Divided into central area CLNM group and non-central area CLNM group according to postoperative pathological results group.Ultrasonic characteristics of thyroid tumor,preoperative TSH levels,preoperative TG levels and general information were recorded in the two groups of patients to perform univariate and multivariate analysis which evaluate the factors that influence CLNM and central area CLNM in PTC patients.Results:1.MTC and CLNM:Single-factor chi-square test analysis showed that the ultrasonic characteristics of tumor size>10 mm,unclear boundary,irregular pattern,capsular invasion,ACR TI-RADS points>5,as well as preoperative calcitonin level>302.50 pg/ml and age ≤52.50 y were risk factors for CLNM in MTC patients(P<0.05).Multivariate logistic regression analysis showed that age ≤52.5y(OR=5.551,95%CI 1.277-24.126,P=0.022),tumor size>10mm(OR=10.023,95%CI 1.346-74.653,P=0.024)and ACR TI-RADS points>5(OR=9.366,95%CI1.074-81.687,P=0.043)were independent risk factors for CLNM in MTC patients.2.MTC and central area CLNM:Single-factor chi-square test analysis showed that the ultrasonic characteristics of tumor size>10 mm,multiple nodules,unclear boundary,irregular pattern,capsular invasion,ACR TI-RADS points>8,as well as preoperative calcitonin level>302.50 pg/ml and age ≤52.5 y were risk factors for central area CLNM in MTC patients(P<0.05).Multivariate logistic regression analysis showed that:there was no statistical significance between age,number of thyroid nodules,capsular invasion,tumor size,boundary,pattern,ACR TI-RADS scoring system score and central area cervical lymph node metastasis in MTC patients(all P>0.05).3.PTC and CLNM:Single-factor chi-square test analysis showed that the ultrasonic characteristics of tumor size>10 mm,multiple nodules,aspect ratio>1,capsular invasion,calcification and ACR point>7,as well as preoperative TG level>14.56 pg/ml and age ≤46.5y were risk factors for CLNM in PTC patients(P<0.05).Multivariate logistic regression analysis showed that age ≤46.5y(OR=2.212,95%CI1.372-3.567,P=0.001),preoperative TG level>14.56 pg/ml(OR=2.999,95%CI1.861-4.831,P<0.001),tumor size>10mm(OR=2.705,95%CI1.552-4.715,P<0.001)and multiple nodules(OR=2.521,95%CI1.534-4.146,P<0.001)were independent risk factors for CLNM in PTC patients.4.PTC and central area CLNM:Single-factor chi-square test analysis showed that the ultrasonic characteristics of tumor size>10 mm,multiple nodules,capsular invasion,calcification and ACR point>7,as well as preoperative TG level>14.56 pg/ml and age ≤46.5 y were risk factors for central area CLNM in PTC patients(P<0.05).Multivariate logistic regression analysis showed that age ≤46.5 y(OR=2.297,95%CI1.430-3.688,P=0.001),preoperative TG level>14.56 pg/ml(OR=2.469,95%CI1.541-3.957,P<0.001),tumor size>10 mm()OR=2.214,95%CI1.286-3.811,P=0.004),multiple nodules(OR=2.385,95%CI1.461-3.895,P=0.001)and calcification(OR=1.831,95%CI1.009-3.324,P=0.047)were independent risk factors for central area CLNM in PTC patients.Conclusion:1.Age≤52.5y,tumor>10mm,ACR TI-RADS points>5 are independent risk factors that affect CLNM in patients with MTC.In addition,preoperative calcitonin>302.50pg/ml are more likely to have CLNM.2.Age≤52.5y,preoperative calcitonin value calcitonin>302.5pg/ml,multiple nodules,capsular invasion,tumor>10mm,unclear boundary,irregular pattern,ACR TI-RADS points>8 are prone to central area CLNM,but these are not independent risk factors.3.Age≤46.5y,preoperative TG level>14.56 ng/ml,tumor>10mm,multiple nodules are independent risk factors that affect CLNM in PTC patients.4.Age≤46.5y,preoperative TG level>14.56 ng/ml,tumor>10mm,multiple nodules and calcification are independent risk factors that affect the central area CLNM in PTC patients.