Early diagnosis and prediction for lateral cervical lymph node metastases of medullary thyroid microcarcinoma
10.3760/cma.j.cn113855-20200805-00615
- VernacularTitle:甲状腺微小髓样癌早期诊断及其侧颈部淋巴结转移的预测分析
- Author:
Jing ZHAO
1
;
Weijing HAO
;
Yiran MAO
;
Jie MU
;
Xiaojie XIN
;
Sheng ZHANG
;
Xiangqian ZHENG
;
Xi WEI
Author Information
1. 天津医科大学肿瘤医院超声诊疗科 300060
- Keywords:
Thyroid neoplasms;
Carcinoma,medullary;
Lymphatic metastasis;
Ultrasonography;
Calcitonin
- From:
Chinese Journal of General Surgery
2021;36(6):416-420
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical and ultrasonographic features for early diagnosis and prediction of lateral cervical lymph node metastasis of medullary thyroid microcarcinoma.Methods:From Jan 2010 to Jan 2020 233 patients undergoing primary surgery were categorized as "medullary thyroid microcarcinoma" and "medullary thyroid macrocarcinoma". The preoperative clinical and ultrasonographic characteristics, the diagnostic positive rate of preoperative serum calcitonin and fine needle aspiration (FNA) were investigated between two groups. All patients with medullary thyroid microcarcinoma were divided on the basis of wether there was lateral cervical lymph node metastasis.Results:There were statistically significant differences in initial diagnostic method(χ 2=32.290, P=0.000), TNM staging(χ 2=50.300, P=0.000) between medullary thyroid microcarcinoma and medullary thyroid macrocarcinoma. Medullary thyroid microcarcinoma showed more malignant ultrasonic features. The diagnostic accuracy of preoperative serum calcitonin was higher than FNA for medullary thyroid micro carcinoma(χ 2=47.933, P=0.000). Multivariate regression analysis demonstrated that the abutment/perimeter ≥1/4( OR=25.475, 95%CI: 2.320-279.771), preoperative serum calcitonin >65 ng/L( OR=32.663, 95%CI:2.433-438.409) were the independent factor for lateral cervical lymph node metastases of medullary thyroid microcarcinoma. Conclusions:The combination of ultrasonography and serum calcitonin helps establish early diagnosis of medullary thyroid microcarcinoma. Medullary thyroid microcarcinoma with the abutment/perimeter ≥1/4, serum calcitonin >65 ng/L predicts lateral cervical lymph node metastases.
