Fu Jiarong, Liu Jinfeng, Wang Zhixiang, Qian Linxue
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Department of Interventional Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Diagnostics (Basel). 2024 Aug 14;14(16):1770. doi: 10.3390/diagnostics14161770.
Papillary thyroid carcinoma (PTC), the predominant pathological type among thyroid malignancies, is responsible for the sharp increase in thyroid cancer. Although PTC is an indolent tumor with good prognosis, 60-70% of patients still have early cervical lymph node metastasis, typically in the central compartment. Whether there is central lymph node metastasis (CLNM) or not directly affects the formulation of preoperative surgical procedures, given that such metastases have been tied to compromised overall survival and local recurrence. However, detecting CLNM before operation can be challenging due to the limited sensitivity of preoperative approaches. Prophylactic central lymph node dissection (PCLND) in the absence of clinical evidence of CLNM poses additional surgical risks. This study aims to provide a comprehensive review of the risk factors related to CLNM in PTC patients. A key focus is on utilizing multimodal ultrasound (US) for accurate prognosis of preoperative CLNM and to highlight the distinctive role of US-based characteristics for predicting CLNM.
甲状腺乳头状癌（PTC）是甲状腺恶性肿瘤中最主要的病理类型，是导致甲状腺癌急剧增加的原因。尽管PTC是一种预后良好的惰性肿瘤，但60%-70%的患者仍有早期颈部淋巴结转移，通常发生在中央区。鉴于这种转移与总体生存率降低和局部复发有关，是否存在中央区淋巴结转移（CLNM）直接影响术前手术方案的制定。然而，由于术前检查方法的敏感性有限，术前检测CLNM具有挑战性。在没有CLNM临床证据的情况下进行预防性中央区淋巴结清扫（PCLND）会带来额外的手术风险。本研究旨在全面综述PTC患者中与CLNM相关的危险因素。重点是利用多模态超声（US）对术前CLNM进行准确预后评估，并强调基于超声特征在预测CLNM方面的独特作用。
