Wang Min, Wu Wei-Dong, Chen Gui-Ming, Chou Sheng-Long, Dai Xue-Ming, Xu Jun-Ming, Peng Zhi-Hai
Department of General Surgery, Shanghai General Hospital of Nanjing Medical University, Nanjing Medical University, Shanghai, China E-mail :
Asian Pac J Cancer Prev. 2015;16(18):8625-8. doi: 10.7314/apjcp.2015.16.18.8625.
Central lymph node metastasis(CLNM) is common in papillary thyroid microcarcinoma (PTMC). The aim of this study was to define the pathohistologic risk grading based on surgical outcomes.
Statistical analysis was performed to figure out the optimal cut-off values of size in preoperative ultrasound images for defining the risk of CLNM in papillary thyroid microcarcinoma. Receiver operating characteristic curves (ROC) studies were carried out to determine the cutoff value(s) for the predictor(s). All the patients were divided into two groups according to the above size and the clinic-pathological and immunohistochemical parameters were compared to determine the significance of findings.
The optimal cut-off value of tumor size to predict the risk of CLNM in papillary thyroid microcarcinoma was 0.575 cm (area under the curve 0.721) according to the ROC curves. Significant differences were observed on the multifocality, extrathyroidal extension and central lymph node metastasis between two groups which were divided according to the tumor size by the cutoff values. Patients in two groups showed different positive rate and intensity of Ki67.
The size of PTMC in ultrasound images are helpful to predict the aggressiveness of the tumors, it could be an easy predictor for PTMC prognosis and assist us to choose treatment.
中央区淋巴结转移(CLNM)在甲状腺微小乳头状癌(PTMC)中很常见。本研究的目的是根据手术结果确定病理组织学风险分级。
进行统计分析以确定术前超声图像中肿瘤大小的最佳截断值,用于定义甲状腺微小乳头状癌中央区淋巴结转移的风险。采用受试者工作特征曲线(ROC)研究来确定预测指标的截断值。根据上述肿瘤大小将所有患者分为两组,比较临床病理和免疫组化参数以确定研究结果的意义。
根据ROC曲线,预测甲状腺微小乳头状癌中央区淋巴结转移风险的肿瘤大小最佳截断值为0.575 cm(曲线下面积为0.721)。根据截断值按肿瘤大小分组的两组在多灶性、甲状腺外侵犯和中央区淋巴结转移方面存在显著差异。两组患者的Ki67阳性率和强度不同。
超声图像中PTMC的大小有助于预测肿瘤的侵袭性,它可以作为PTMC预后的一个简单预测指标,并帮助我们选择治疗方案。