Capsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study

Abstract Background In patients with papillary thyroid cancer (PTC), cervical lymph node metastasis (LNM) must be carefully assessed to determine the extent of lymph node dissection required and patient prognosis. Few studies attempted to determine whether the ultrasound (US) appearance of the prima...

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Autores principales:	Lei Ye, Lei Hu, Weiyong Liu, Yuanyuan Luo, Zhe Li, Zuopeng Ding, Chunmei Hu, Lin Wang, Yajuan Zhu, Le Liu, Xiaopeng Ma, Yuan Kong, Liangliang Huang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Ultrasonography Thyroid cancer, papillary Metastasis Lymph nodes Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/d2d9892621b747e29104970414f33d02
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spelling	oai:doaj.org-article:d2d9892621b747e29104970414f33d022021-11-21T12:30:34ZCapsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study10.1186/s12885-021-08875-51471-2407https://doaj.org/article/d2d9892621b747e29104970414f33d022021-11-01T00:00:00Zhttps://doi.org/10.1186/s12885-021-08875-5https://doaj.org/toc/1471-2407Abstract Background In patients with papillary thyroid cancer (PTC), cervical lymph node metastasis (LNM) must be carefully assessed to determine the extent of lymph node dissection required and patient prognosis. Few studies attempted to determine whether the ultrasound (US) appearance of the primary thyroid tumor could be used to predict cervical lymph node involvement. This study aimed to identify the US features of the tumor that could predict cervical LNM in patients with PTC. Methods This was a retrospective study of patients with pathologically confirmed PTC. We evaluated the following US characteristics: lobe, isthmus, and tumor size; tumor position; parenchymal echogenicity; the number of lesions (i.e., tumor multifocality); parenchymal and lesional vascularity; tumor margins and shape; calcifications; capsular extension; tumor consistency; and the lymph nodes along the carotid vessels. The patients were grouped as no LNM (NLNM), central LNM (CLNM) alone, and lateral LNM (LLNM) with/without CLNM, according to the postoperative pathological examination. Results Totally, 247 patients, there were 67 men and 180 women. Tumor size of > 10 mm was significantly more common in the CLNM (70.2%) and LLNM groups (89.6%) than in the NLNM group (45.4%). At US, capsular extension > 50% was most common in the LLNM group (35.4%). The multivariable analysis revealed that age (OR = 0.203, 95%CI: 0.095–0.431, P < 0.001) and tumor size (OR = 2.657, 95%CI: 1.144–6.168, P = 0.023) were independently associated with CLNM compared with NLNM. In addition, age (OR = 0.277, 95%CI: 0.127–0.603, P = 0.001), tumor size (OR = 6.069, 95%CI: 2.075–17.75, P = 0.001), and capsular extension (OR = 2.09, 95%CI: 1.326–3.294, P = 0.001) were independently associated with LLNM compared with NLNM. Conclusion Percentage of capsular extension at ultrasound is associated with LLNM. US-guided puncture cytology and eluent thyroglobulin examination could be performed as appropriate to minimize the missed diagnosis of LNM.Lei YeLei HuWeiyong LiuYuanyuan LuoZhe LiZuopeng DingChunmei HuLin WangYajuan ZhuLe LiuXiaopeng MaYuan KongLiangliang HuangBMCarticleUltrasonographyThyroid cancer, papillaryMetastasisLymph nodesNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBMC Cancer, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ultrasonography Thyroid cancer, papillary Metastasis Lymph nodes Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Ultrasonography Thyroid cancer, papillary Metastasis Lymph nodes Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Lei Ye Lei Hu Weiyong Liu Yuanyuan Luo Zhe Li Zuopeng Ding Chunmei Hu Lin Wang Yajuan Zhu Le Liu Xiaopeng Ma Yuan Kong Liangliang Huang Capsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study
description	Abstract Background In patients with papillary thyroid cancer (PTC), cervical lymph node metastasis (LNM) must be carefully assessed to determine the extent of lymph node dissection required and patient prognosis. Few studies attempted to determine whether the ultrasound (US) appearance of the primary thyroid tumor could be used to predict cervical lymph node involvement. This study aimed to identify the US features of the tumor that could predict cervical LNM in patients with PTC. Methods This was a retrospective study of patients with pathologically confirmed PTC. We evaluated the following US characteristics: lobe, isthmus, and tumor size; tumor position; parenchymal echogenicity; the number of lesions (i.e., tumor multifocality); parenchymal and lesional vascularity; tumor margins and shape; calcifications; capsular extension; tumor consistency; and the lymph nodes along the carotid vessels. The patients were grouped as no LNM (NLNM), central LNM (CLNM) alone, and lateral LNM (LLNM) with/without CLNM, according to the postoperative pathological examination. Results Totally, 247 patients, there were 67 men and 180 women. Tumor size of > 10 mm was significantly more common in the CLNM (70.2%) and LLNM groups (89.6%) than in the NLNM group (45.4%). At US, capsular extension > 50% was most common in the LLNM group (35.4%). The multivariable analysis revealed that age (OR = 0.203, 95%CI: 0.095–0.431, P < 0.001) and tumor size (OR = 2.657, 95%CI: 1.144–6.168, P = 0.023) were independently associated with CLNM compared with NLNM. In addition, age (OR = 0.277, 95%CI: 0.127–0.603, P = 0.001), tumor size (OR = 6.069, 95%CI: 2.075–17.75, P = 0.001), and capsular extension (OR = 2.09, 95%CI: 1.326–3.294, P = 0.001) were independently associated with LLNM compared with NLNM. Conclusion Percentage of capsular extension at ultrasound is associated with LLNM. US-guided puncture cytology and eluent thyroglobulin examination could be performed as appropriate to minimize the missed diagnosis of LNM.
format	article
author	Lei Ye Lei Hu Weiyong Liu Yuanyuan Luo Zhe Li Zuopeng Ding Chunmei Hu Lin Wang Yajuan Zhu Le Liu Xiaopeng Ma Yuan Kong Liangliang Huang
author_facet	Lei Ye Lei Hu Weiyong Liu Yuanyuan Luo Zhe Li Zuopeng Ding Chunmei Hu Lin Wang Yajuan Zhu Le Liu Xiaopeng Ma Yuan Kong Liangliang Huang
author_sort	Lei Ye
title	Capsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study
title_short	Capsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study
title_full	Capsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study
title_fullStr	Capsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study
title_full_unstemmed	Capsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study
title_sort	capsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d2d9892621b747e29104970414f33d02
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Capsular extension at ultrasound is associated with lateral lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study

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