Value of conventional ultrasound features, contrast-enhanced ultrasound parameters and serum TSH and TgAb levels in predicting central lymph node metastasis of papillary thyroid carcinoma
10.3760/cma.j.cn115355-20240102-00003
- VernacularTitle:常规超声特征、超声造影参数及血清TSH、TgAb水平对甲状腺乳头状癌中央区淋巴结转移的预测价值
- Author:
Jin TANG
1
;
Bo ZHANG
Author Information
1. 山西省肿瘤医院 中国医学科学院肿瘤医院山西医院 山西医科大学附属肿瘤医院超声科，太原 030013
- Keywords:
Thyroid neoplasms;
Carcinoma, papillary;
Lymphatic metastasis;
Ultrasonography;
Lymphography;
Thyrotropin;
Anti-thyroglobulin antibody
- From:
Cancer Research and Clinic
2024;36(10):762-766
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of conventional ultrasound features and contrast-enhanced ultrasound parameters combined with serum levels of anti-thyroglobulin antibody (TgAb) and thyroid stimulating hormone (TSH) in predicting central lymph node metastasis of papillary thyroid carcinoma (PTC).Methods:A retrospective case series study was conducted. The clinical data of 123 patients diagnosed with PTC by postoperative pathology at Shanxi Province Cancer Hospital from January 2020 to August 2023 were analyzed. According to the pathological results of cervical lymph nodes, the patients were divided into lymph node metastasis group (58 cases) and lymph node non-metastasis group (65 cases). The nodules were observed using conventional ultrasound and the signs of PTC nodules were recorded, and whether there was metastasis in the cervical lymph nodes was observed; the enhancement patterns of the target nodules were recorded using contrast-enhanced ultrasound technology, and the peak intensity (PI), time to peak (TTP) and mean transition time (MTT) were calculated; the serum TSH and TgAb levels were detected using radioimmunoassay. The results of logistic regression analysis were used to build formulas for predicting the metastasis of central lymph nodes in PTC based on conventional ultrasound features, contrast-enhanced ultrasound parameters, serum TSH level, serum TgAb level, and a combination of the 4 indicators. Using pathological results as the gold standard, receiver operating characteristic (ROC) curves of the indicators for predicting the metastasis of central lymph nodes in PTC were plotted to analyze the predictive performance of each indicator.Results:There were no statistically significant differences in baseline data between the lymph node metastasis group and the lymph node non-metastasis group (all P > 0.05). There were statistically significant differences in the proportions of patients with capsule contact, uniform echo texture, calcification and longest diameter of nodules between the two groups (all P < 0.05). The serum TSH and TgAb levels in patients of lymph node metastasis group were higher than those in patients of non-metastasis group, and the differences were statistically significant (both P < 0.05); the nodule contrast-enhanced ultrasound parameters PI, MTT and TTP in lymph node metastasis group were lower than those in non-metastasis group, and the differences were sttistically significant (all P < 0.05). Logistic regression analysis yielded the predictive formulas, conventional ultrasound features: logit ( P) = 1.017×capsule contact-1.079×calcification focus+0.899×longest diameter of nodule; contrast-enhanced ultrasound parameters: logit ( P) = 0.053×PI+0.034×MTT+0.080×TTP; contrast-enhanced ultrasound parameters combined with TSH and TgAb: logit( P)=0.062×PI+0.034×MTT+0.093×TTP-0.080×TSH-0.450×TgAb; a combination of the 4 indicators: logit( P) = 1.259×capsule contact-0.921×calcification focus+0.955×longest diameter of nodule+0.054×PI+0.016×MTT+0.099×TTP-0.300×TSH-0.516×TgAb. The area under the curve (AUC) for predicting central lymph node metastasis in PTC using conventional ultrasound features was 0.74, the AUC of contrast-enhanced ultrasound parameters was 0.76, the AUC of contrast-enhanced ultrasound parameters combined with TSH and TgAb was 0.64, the AUC of a combination of the 4 indicators was 0.87. Conclusions:The combination of conventional ultrasound features, contrast-enhanced ultrasound parameters and serum TgAb and TSH levels has good predictive value for central lymph node metastasis in PTC.
