Correlation Analysis of Papillary Thyroid Carcinoma on Sonographic Features and Cervical Lymph Node Metastasis

Abstract

Background Papillary thyroid carcinoma (PTC) is the most common pathological type of thyroid carcinoma. We aim to evaluate the correlation between sonographic features of PTC and cervical lymph node metastasis (CLNM). Methods A total of 1335 patients who underwent thyroidectomy and had pathologically confirmed unifocal PTC were enrolled in the retrospective research. Univariate analysis and logistic analysis were performed to predict CLNM by several independent variables. Receiver operating characteristic (ROC) curve was executed to evaluate the diagnostic performance. Results Univariate analysis showed that location, aspect ratio, margin, echogenic foci, TI-RADS score and grade were related to CLNM (P<0.05). Logistic analysis on sonographic features showed that margin and echogenic foci were independent correlative factors. Meanwhile, logistic analysis included clinical information, ultrasonic measurements and sonographic features showed that gender, age, tumour maximum diameter and volume, cross-sectional aspect ratio, location, margin and echogenic foci were independent correlative factors. The ROC curves were established based on the relevant factors, the AUC of tumour maximum diameter, tumour volume and margin were 0.738, 0.733, and 0.711, respectively. The regression model was constructed with AUC of 0.813, specificity of 70.3%, and sensitivity of 78.5%. ANOVA variance analysis on positive and negative group, tumour maximum diameter, margin, echogenic foci, TI-RADS score and grade had statistical significance (P < 0.05). Conclusion Lower location, larger lesion, margin and echogenic foci were high risk factors for CLNM in PTC, cross-sectional aspect ratio≥1 had more effective predictive value than longitudinal-sectional aspect ratio. Tumor volume was more effective to evaluate the lateral metastasis than maximum tumour diameter, it could guide preoperative FNA for CLNM.