Clinical Value of Ultrasonography and Serum Markers in Preoperative N Staging of Thyroid Cancer

Abstract

We aimed to determine factors influencing lymph node metastasis (LNM) and develop a more effective method to assess preoperative N staging. Overall, data of 2130 patients who underwent thyroidectomy for thyroid cancer between 2018 and 2021 were retrospectively analysed. Patients were divided into groups according to pN0, pN1a, and pN1b stages. Pathology was used to analyse the correlation between preoperative serum marker indicators and LNM. Receiver operating characteristic curves were used to compare the diagnostic value of ultrasound (US) examination alone, serum thyroglobulin, age, and combined method for LNM. A significant moderate agreement was observed between preoperative US and postoperative pathology for N staging. Between the pN0 and pN1 (pN1a + pN1b) groups, the differences in free triiodothyronine, anti-thyroid peroxidase antibody, and serum thyroglobulin levels were statistically significant. Among the indicators, serum thyroglobulin was an independent predictor of LNM. The area under the receiver operating characteristic curve was 0.610 for serum thyroglobulin level for predicting LNM, 0.689 for US alone, and 0.742 for the combined method. Both preoperative US and serum thyroglobulin level provide a specific value when evaluating the N staging of thyroid cancer, and the combined method is more valuable in the diagnosis of LNM than US alone.

Prognostic factors for postoperative papillary thyroid cancer with unexplained elevated Tg: A retrospective study

“…Distinguishing small lymph node lesions can be challenging due to postoperative scar formation and neck edema, which can obscure the lesions and make them difficult to identify. Furthermore, the restricted ability of ultrasound to detect mediastinal lesions may result in misdiagnosis [ 12 , 13 ]. On the other hand, 131 I scan offers superior detection of functional lesions compared to CT. To some extent, this demonstrates the value of RAT.…”

Clinical outcome and influencing factors for postoperative papillary thyroid cancer with unexplained elevated Tg prior 131I therapy

“…It is di cult to distinguish small lymph node lesions due to postoperative neck edema and scar formation. In addition, the limited range of ultrasound detection for mediastinal lesions may result in misdiagnosis [11,12]. On the other hand, 131 I scan are obviously superior to CT in detecting functional lesions.…”

A novel nomogram integrated with preablation stimulated thyroglobulin and thyroglobulin/thyroid-stimulating hormone ratio to predict the therapeutic response of intermediate‑ and high‑risk differentiated thyroid cancer patients: a bi-center retrospective study

“…This study provided evidence for this option. In addition, Wang et al [21] proposed that Tg levels were correlated with LNM. On the one hand, LNM is common in DTC [22].…”