Mu Jiali, Liang Xiaofeng, Li Fangxuan, Liu Juntian, Zhang Sheng, Tian Jing
Department of Ultrasound.
Department of Cancer Prevention Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
Cancer Biol Med. 2018 May;15(2):171-177. doi: 10.20892/j.issn.2095-3941.2017.0092.
Extranodal extension in cervical lymph nodes is an important risk factor for the progression and prognosis of papillary thyroid cancer. The purpose of this study was to identify the common and characteristic preoperative ultrasonography features that are associated with the pathologic extranodal extension of metastatic papillary thyroid carcinoma.
We retrospectively assessed and compared clinicopathologic and ultrasound features between 60 papillary thyroid cancer patients with extranodal extension and 120 control patients with papillary thyroid cancer without extranodal extension.
With respect to the pathological N stage and clinicopathologic features, N1b stage papillary thyroid carcinomas were more frequently found in patients who were extranodal extension-positive, in comparison with those who were extranodal extension-negative (78.3% 63.3%, =0.043). Extranodal extension was detected most frequently in level VI cervical lymph nodes (48.7%). In our univariate analysis of patients with papillary thyroid carcinoma, cervical lymph nodes with extranodal extension showed higher incidences of node matting, microcalcification, cystic area, aspect ratio <2, and larger diameter than those without extranodal extension (all <0.05). Our multivariate analysis demonstrated that node matting and cystic area were independent risk factors for the presence of extranodal extension [odds ratio (): 4.751, 95% confidence interval (CI): 1.21218.626, =0.025; : 2.707, 95% CI: 1.1276.502, =0.026].
Common ultrasound features may indicate the presence of extranodal extension in patients with metastatic cervical lymph nodes of papillary thyroid carcinoma.
颈部淋巴结的结外侵犯是影响甲状腺乳头状癌进展及预后的重要危险因素。本研究旨在确定与转移性甲状腺乳头状癌病理结外侵犯相关的常见及特征性术前超声特征。
我们回顾性评估并比较了60例有结外侵犯的甲状腺乳头状癌患者与120例无结外侵犯的甲状腺乳头状癌对照患者的临床病理及超声特征。
在病理N分期及临床病理特征方面，与结外侵犯阴性患者相比，结外侵犯阳性患者中N1b期甲状腺乳头状癌更为常见（78.3%对63.3%，P = 0.043）。结外侵犯最常发生于Ⅵ区颈部淋巴结（48.7%）。在我们对甲状腺乳头状癌患者的单因素分析中，有结外侵犯的颈部淋巴结与无结外侵犯的相比，出现淋巴结融合、微钙化、囊性区域、纵横比<2及直径更大的发生率更高（均P<0.05）。我们的多因素分析表明，淋巴结融合和囊性区域是结外侵犯存在的独立危险因素[比值比（OR）：4.751，95%置信区间（CI）：1.21 < 218.626，P = 0.025；OR：2.707，95% CI： < 1.1276.502，P = 0.026]。
常见的超声特征可能提示甲状腺乳头状癌转移性颈部淋巴结患者存在结外侵犯。
