Study of high-risk factors for cervical lymph node metastasis in papillary carcinoma of the thyroid isthmus
10.3760/cma.j.cn131148-20250510-00270
- VernacularTitle:甲状腺峡部乳头状癌颈部淋巴结转移的高危因素分析
- Author:
Ziyi CHEN
1
;
Tian JIANG
;
Chen CHEN
;
Lingyan ZHOU
Author Information
1. 浙江中医药大学研究生院，杭州 310053
- Publication Type:Journal Article
- Keywords:
Ultrasonography;
Papillary thyroid carcinoma;
Isthmus;
Ultrasonographic features;
Lymph node metastasis
- From:
Chinese Journal of Ultrasonography
2025;34(11):976-982
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the ultrasonographic features and risk factors of patients with papillary thyroid carcinoma（PTC）located in the isthmus of the thyroid gland combined with lymph node metastasis（LNM）.Methods:A retrospective analysis was performed on a cohort of 614 patients diagnosed with isthmic PTC through postoperative pathological confirmation at Zhejiang Cancer Hospital between January 2020 and June 2024. The patients were divided into the LNM group（ n=225）and non-LNM（ n=389）based on the pathological results. The baseline information and ultrasound characteristics of the nodules were compared between the two groups. The risk factors associated with the development of LNM in patients with isthmus PTC were explored using univariate and multivariate Logistic regression analysis. The predictive performance was analyzed using ROC curve. Results:Comparison of the baseline information revealed that the age，maximum diameter of the cancerous lesion，gender were statistically different between LNM group and non-LNM group（all P<0.05）. Comparison of thyroid nodule ultrasound characteristics showed that there were statistically significant differences in boundary，aspect ratio，calcification，and color Doppler blood flow imaging（CDFI）grades between the two groups（all P<0.05）. Univariate and multifactorial Logistic regression analyses showed that the maximum diameter of the cancer foci（ OR=1.180，95% CI=1.119-1.244），gender is female（ OR=1.798，95% CI=1.187-2.723），and microcalcification（ OR=1.509，95% CI=0.183-12.441）were the factors affecting LNM of the isthmus PTC. The AUC value of the model used to predict the occurrence of LNM in isthmus PTC was 0.756（95% CI=0.717 - 0.795），with a sensitivity of 75.8% and a specificity of 63.6%. Conclusions:The maximum diameter of the cancer foci，microcalcification and gender female were independent risk factors for the occurrence of LNM in patients with thyraid isthmus PTC. The model constructed based on the above characteristics has a better predictive performance for thyroid isthmus PTC with LNM，and patients with the above high-risk character istics should be more vigilant.
