Lee Ji Ye, Yoo Roh-Eul, Rhim Jung Hyo, Lee Kyung Hoon, Choi Kyu Sung, Hwang Inpyeong, Kang Koung Mi, Kim Ji-Hoon
Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea.
Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 156707, Korea.
Cancers (Basel). 2022 Apr 23;14(9):2106. doi: 10.3390/cancers14092106.
A malignancy risk stratification system (RSS) for cervical lymph nodes (LNs) has not been fully established. This study aimed to validate the current RSS for the diagnosis of cervical LN metastasis in thyroid cancer. In total, 346 LNs from 282 consecutive patients between December 2006 and June 2015 were included. We determined the malignancy risk of each ultrasound (US) feature and performed univariable and multivariable logistic regression analyses. Each risk category from the Korean Society of Thyroid Radiology (KSThR) and the European Thyroid Association (ETA) was applied to calculate malignancy risks. The effects of size, number of suspicious features, and primary tumor characteristics were analyzed to refine the current RSS. Suspicious features including echogenic foci, cystic change, hyperechogenicity, and abnormal vascularity were independently predictive of malignancy ( ≤ 0.045). The malignancy risks of probably benign, indeterminate, and suspicious categories were 2.2-2.5%, 26.8-29.0%, and 85.8-87.4%, respectively, according to the KSThR and ETA criteria. According to the ETA criteria, 15.1% of LNs were unclassifiable. In indeterminate LNs, multiplicity of the primary tumor was significantly associated with malignancy (odds ratio, 6.53; = 0.004). We refined the KSThR system and proposed a US RSS for LNs in patients with thyroid cancer.
用于颈部淋巴结（LNs）的恶性风险分层系统（RSS）尚未完全建立。本研究旨在验证当前的RSS用于诊断甲状腺癌颈部LN转移的情况。总共纳入了2006年12月至2015年6月期间282例连续患者的346个LNs。我们确定了每个超声（US）特征的恶性风险，并进行了单变量和多变量逻辑回归分析。应用韩国甲状腺放射学会（KSThR）和欧洲甲状腺协会（ETA）的每个风险类别来计算恶性风险。分析了大小、可疑特征数量和原发肿瘤特征的影响，以完善当前的RSS。包括回声灶、囊性变、高回声和异常血管等可疑特征可独立预测恶性（≤0.045）。根据KSThR和ETA标准，可能良性、不确定和可疑类别的恶性风险分别为2.2 - 2.5%、26.8 - 29.0%和85.8 - 87.4%。根据ETA标准，15.1%的LNs无法分类。在不确定的LNs中，原发肿瘤的多灶性与恶性显著相关（比值比，6.53； = 0.004）。我们完善了KSThR系统，并提出了用于甲状腺癌患者LNs的US RSS。
