Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Front Endocrinol (Lausanne). 2023 Jul 12;14:1187825. doi: 10.3389/fendo.2023.1187825. eCollection 2023.
The lymph node posterior to the right recurrent laryngeal nerve (LN-prRLN) is a crucial component of the central lymph nodes (LNs). We aimed to evaluate multimodal predictive factors of LN-prRLN metastasis in patients with papillary thyroid carcinomas (PTCs), including the clinical data, pathologic data, and preoperative sonographic characteristics of PTCs.
A total of 403 diagnosed PTC patients who underwent unilateral, sub-total, or total thyroidectomy with central neck dissection were enrolled in this retrospective study. The clinical data, pathologic data, conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) characteristics of PTCs were collected and evaluated for predicting LN-prRLN metastasis.
In this study, 96 PTC patients with LN-prRLN metastasis and 307 PTC patients without LN-prRLN metastasis were included. Univariate analysis demonstrated that PTC patients with LN-prRLN metastasis more often had younger age, larger size, multifocal cancers, A/T < 1, well-margins, microcalcification, petal-like calcification, internal vascularity, centripetal perfusion pattern and surrounding ring enhancement. Multivariate logistic regression analysis revealed that the CEUS centripetal perfusion pattern, central LN detected by ultrasound and LN-arRLN metastasis were independent characteristics for predicting LN-prRLN metastasis in PTC patients.
According to our research, it is essential for clinicians to thoroughly dissect central LNs, particularly LN-prRLNs.
右喉返神经后淋巴结（LN-prRLN）是中央淋巴结（LNs）的重要组成部分。我们旨在评估包括甲状腺乳头状癌（PTC）患者临床资料、病理资料和术前超声特征在内的多种模态预测因素，以预测 LN-prRLN 转移。
本回顾性研究共纳入 403 例接受单侧、次全或全甲状腺切除术和中央颈部清扫术的诊断为 PTC 的患者。收集并评估 PTC 的临床资料、病理资料、常规超声（US）和超声造影（CEUS）特征，以预测 LN-prRLN 转移。
本研究中，96 例 PTC 患者发生 LN-prRLN 转移，307 例 PTC 患者未发生 LN-prRLN 转移。单因素分析表明，发生 LN-prRLN 转移的 PTC 患者更年轻、肿瘤更大、多灶性、纵横比（A/T）＜1、边界清晰、微钙化、花瓣样钙化、内部血管化、向心性灌注模式和周围环状增强。多因素 logistic 回归分析显示，CEUS 向心性灌注模式、超声检测的中央 LN 和 LN-arRLN 转移是预测 PTC 患者 LN-prRLN 转移的独立特征。
根据我们的研究，临床医生彻底解剖中央 LNs，特别是 LN-prRLN 是至关重要的。
