|Table of Contents|

Clinical study of central zone lymph node metastasis of papillary thyroid carcinoma of the isthmus

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 07
Page:
1249-1254
Research Field:
Publishing date:

Info

Title:
Clinical study of central zone lymph node metastasis of papillary thyroid carcinoma of the isthmus
Author(s):
WANG Jiabao1; ZHAO Ge2; MA Xin1; LIANG Yinbo1; HOU Chunmei1
1.Shanxi Medical University,Shanxi Taiyuan 030001,China;2.Department of General Surgery,the Second Hospital of Shanxi Medical University,Shanxi Taiyuan 030001,China.
Keywords:
papillary thyroid carcinoma; papillary thyroid carcinoma of the isthmus; peritoneal invasion; bilateral central lymph nodes; tumor size
PACS:
R739.91
DOI:
10.3969/j.issn.1672-4992.2024.07.011
Abstract:
Objective:To explore the rule of central zone lymph node metastasis of papillary thyroid carcinoma in the isthmus(PTCI) and its risk factors,and to provide clinical basis for the scope of lymph node dissection in PTCI.Methods:We retrospectively analyzed the clinical data of 538 patients with papillary thyroid carcinoma(PTC) who underwent radical thyroid cancer treatment at the general surgery department of our hospital from June 2010 to June 2023,and classified them into the PTCI group(n=62 cases) and unilateral glandular lobe PTC group(n=476 cases) according to the location of the tumors,and analyzed the general data of the patients with PTCI and unilateral glandular lobe PTC by using the t-test for independent samples or the χ2 test.We further analyzed the difference of central regional lymph node metastasis between PTCI and unilateral glandular lobe PTC patients by χ2 test,and analyzed the independent influencing factors of bilateral central regional lymph node metastasis of PTCI by multifactorial Logistic regression.The predictive value of tumor size in BCLN metastasis in patients with PTCI was analyzed using plotting the reciver operating characteristic curve(ROC) and area under the curve(AUC).Results:In this study,there were statistically significant differences between the PTCI group and the unilateral glandular lobe PTC group in terms of tumor size,lymph node metastasis,peripheral invasion,and multifocality(P＜0.05).In bilateral central lymph node(BCLN) dissection,the rate of bilateral central lymph node metastasis was higher in patients in the PTCI group than in the unilateral glandular lobe PTC group,the difference was statistically significant(P＜0.05),and the unilateral central region of patients in the unilateral glandular lobe PTC group was higher than that of the PTCI group,and the difference was statistically significant(P＜0.05).The results of binary Logistic regression showed that the size of isthmus tumors was an independent risk factor for BCLN metastasis in patients with PTCI(P＜0.05).The predictive value of PTCI tumor size for BCLN metastasis was analyzed using ROC,and the AUC was 0.807(95%CI:0.670~0.944,P＜0.05),with an optimal threshold(Cut-off value) of 0.65 cm,and a sensitivity and specificity of 90.5% and 65%,respectively.Conclusion:Patients with PTCI have smaller tumors,higher lymph node metastasis,higher peripheral invasion,more common multifocality,and are more likely to have BCLN metastasis.PTCI tumor size is an independent influencing factor for BCLN metastasis.PTCI cancer focus≥0.65 cm are predictive of BCLN metastasis,and should be subjected to bilateral central lymph node dissection.

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Last Update: 2024-02-29