Clinical analysis of cervical lymph node metastasis risk factors in patients with papillary thyroid microcarcinoma

Luo, Yan; Zhao, Yupei; Chen, K.; Shen, Jiacheng; Shi, Jingjing; Si, Lu; Lei, Jianyong; Li, Z.; Luo, Dingcun

doi:10.1007/s40618-018-0908-y

Cited by 66 publications

(53 citation statements)

References 31 publications

(31 reference statements)

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“…Our results are similar to a study by Kwak et al who showed a rate of lateral metastasis of 3.7% in their cohort [21]. However, Luo et al showed a rate of 5.6% of lateral LN metastasis, and this was associated with multifocality and ETE [22]. Our results confirmed that U/S mapping is a highly reliable and accurate tool in identifying metastatic LN and guiding the surgeon for precise neck dissection.…”

Section: Discussionsupporting

confidence: 91%

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Lymph Node Metastasis and Extrathyroidal Extension in Papillary Thyroid Microcarcinoma in Cyprus: Suspicious Subcentimeter Nodules Should Undergo FNA When Multifocality is Suspected

Papaioannou

Lamnisos

Kyriacou³

et al. 2020

Journal of Thyroid Research

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Objective. To determine the prevalence of lymph node (LN) metastasis and extrathyroidal extension (ETE) in patients with papillary thyroid microcarcinoma (PTMC) in Cyprus and to evaluate the role of preoperative ultrasound (U/S) examination. Methods. A retrospective study of 102 patients who underwent thyroidectomy for PTMC in a 2-year period. Preoperatively, all patients had a thyroid and neck U/S examination with LN mapping. Tumor size according to the largest diameter, number of foci, LN metastasis, and ETE data was collected from the histopathological report and was compared to the preoperative U/S reports. Results. LN metastasis was present in 23.5% of patients. 15.7% had central, 3.9% had lateral, and 3.9% had both central and lateral LN metastasis. ETE was present in 27.5% of patients. 21.6% had multifocal disease, and in this group, 40.9% had LN metastasis and 36.4% had ETE. Multifocality (p=0.03), size of tumor (p=0.05), and ETE (p≤0.001) were significantly associated with LN metastasis. The prevalence of LN metastasis in multifocal PTMC ≤5 mm was the same with multifocal PTMC >5 mm. The preoperative U/S sensitivity for the suspicious lateral neck and central LN was 100%, and the specificity was 100%. The preoperative U/S sensitivity for nodules suspicious for ETE was 53.6%, and the specificity was 100%. Conclusion. The presence of LN metastasis and ETE in our PTMC patients in Cyprus is frequent. Neck U/S mapping is a highly reliable and accurate tool in identifying metastatic nodes. LN metastasis is associated with ETE and multifocality. Suspicious subcentimeter nodules should undergo FNA irrespective of size when multifocality is suspected.

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Section: Discussionsupporting

confidence: 91%

“…Central LN metastasis can occur in up to 29.3% and lateral lymph node metastasis in 3.7-5.6% of PTMC patients [20][21][22], and this is associated with locoregional re-occurrence and adverse outcomes [23,24]. ETE is another risk factor that can affect the decision for total vs. hemithyroidectomy [16,25].…”

Section: Introductionmentioning

confidence: 99%

Lymph Node Metastasis and Extrathyroidal Extension in Papillary Thyroid Microcarcinoma in Cyprus: Suspicious Subcentimeter Nodules Should Undergo FNA When Multifocality is Suspected

Papaioannou

Lamnisos

Kyriacou³

et al. 2020

Journal of Thyroid Research

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“…However, the clinical stage of ETE belongs to T3, so we excluded ETE in this study. Tumor location at the superior pole and ipsilateral central lymph node positivity are also independent high-risk factors for lateral neck metastasis in PTMC patients, consistent with other studies [20,21] . However, our study did not find that sex, multifocality or age were high-risk factors for LNLN metastasis.…”

Section: Discussionsupporting

confidence: 91%

High-risk factors for ipsilateral lateral neck lymph node metastasis in clinically node-negative patients with papillary thyroid microcarcinoma (cT1aN0)

Zhou¹,

Lin²,

Qin³

2020

Preprint

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Background: The incidence of papillary thyroid microcarcinoma (PTMC) increases yearly. There are several studies on the high-risk factors for lymph node metastasis in the central compartment of PTMC but few studies on the high-risk factors for lateral neck lymph node (LNLN) metastasis. Few studies have analyzed the high-risk factors for LNLN metastasis for clinically lymph node-negative PTMC patients in stage T1a (cT1aN0). We investigated the risk factors for LNLN metastasis in these patients. Methods: In total, 127 PTMC (cT1aN0) patients underwent hemi-or total thyroidectomy with ipsilateral central lymph node dissection (CLND) plus lateral lymph node dissection (LLND), including levels III and IV, between 2018 and 2019 in our hospital. Univariate and multivariate analyses identified the high-risk factors for LNLN metastasis in PTMC (cT1aN0). Results: The rate of LNLN metastasis was 21.26% (27/127). The multivariate analysis showed that capsular invasion (p=0.027), tumor location at the superior pole (p=0.002) and ipsilateral central lymph node positivity (p=0.001) were independent risk factors for LNLN metastasis in PTMC patients (cT1aN0), with odds ratios (ORs) of 0.181 (95% confidence interval (95% CI): 0.039-0.827), 5.994 (95% CI: 1.949-18.435) and 6.182 (95% CI: 2.193-17.425), respectively. Conclusions: These findings indicate that capsular invasion, tumor location at the superior pole and ipsilateral central lymph node positivity are independent high-risk factors for LNLN metastasis in clinically node-negative PTMC (cT1aN0) patients. High-risk factors should be correctly evaluated to guide surgical treatment for PTMC patients.

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“…There is a well-documented, worldwide trend showing an rapid increasing incidence of PTC in recent decades (2)(3)(4). This increase has been predominantly an increase in PTMC, accounting for 50% of PTCs (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Combination of serum microRNAs and ultrasound profile as predictive biomarkers of diagnosis and prognosis for papillary thyroid microcarcinoma

Zhang

Pan

et al. 2018

Oncol Rep

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Circulating microRNAs (miRNAs) are promising diagnostic markers in various types of cancers, including papillary thyroid carcinoma (PTC). However, there is sparse information reported with regards to miRNA expression in papillary thyroid microcarcinoma (PTMC) or concerning the role of a combination of miRNAs and ultrasound (US) in the diagnosis of PTMC before surgery. Therefore, we designed a study that aimed to evaluate miRNA expression levels and their potential associations with US findings and determine whether miRNAs could be used as diagnostic and prognostic biomarkers of PTMC. miR-222, miR-221, miR-146b and miR-21 levels were determined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) in serum from 58 patients with PTMC and 47 with PTC, 35 patients with benign thyroid nodules (BTN) and 40 control subjects. Expression levels of the four miRNAs in serum were evaluated before and after surgery. The results indicated that miR-222, miR-221, miR-146b and miR-21 expression levels were higher in the PTMC samples than in those from the BTN and control groups and the combination of miRNAs and US had a high sensitivity and specificity for discrimination between BTN and PTMC by receiver operating characteristic (ROC) curve analysis and improved the accuracy of diagnosis of PTMC before surgery. In addition, serum miRNA expression levels were significantly related to poor prognostic factors including metastatic lymph nodules (MLNs), multifocal and bilateral lesions, advanced stage and high-risk PTMC patients. The miRNA expression levels in serum from PTMC patients were rapidly reduced after surgery compared with levels before surgery. In addition, we also analyzed the miRNA expression levels in serum from patients who were divided into two groups according to factors indicating a good or poor prognosis associated with PTMC after surgery. The results suggested that after surgery, the miR-222, miR-146b and miR-21 expression levels were significantly higher in the poor prognosis group compared with these levels in the good prognosis group. Serum miRNA expression levels helped distinguish between benign and malignant nodules and were associated with a poor prognosis in PTMC. Circulating miRNAs may be useful as follow-up biomarkers and as diagnostic and prognostic tools.

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Clinical analysis of cervical lymph node metastasis risk factors in patients with papillary thyroid microcarcinoma

Cited by 66 publications

References 31 publications

Lymph Node Metastasis and Extrathyroidal Extension in Papillary Thyroid Microcarcinoma in Cyprus: Suspicious Subcentimeter Nodules Should Undergo FNA When Multifocality is Suspected

Lymph Node Metastasis and Extrathyroidal Extension in Papillary Thyroid Microcarcinoma in Cyprus: Suspicious Subcentimeter Nodules Should Undergo FNA When Multifocality is Suspected

High-risk factors for ipsilateral lateral neck lymph node metastasis in clinically node-negative patients with papillary thyroid microcarcinoma (cT1aN0)

Combination of serum microRNAs and ultrasound profile as predictive biomarkers of diagnosis and prognosis for papillary thyroid microcarcinoma

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