Xu Yuxing, Zhang Chao
Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China.
Department of General Surgery, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui 230031, P.R. China.
Oncol Lett. 2024 Aug 1;28(4):472. doi: 10.3892/ol.2024.14605. eCollection 2024 Oct.
Neck lymphatic metastasis is a common occurrence with thyroid cancers, and pre operative lateral lymph node metastasis (LLNM) and postoperative lateral lymph node recurrence (LLNR) are two independent risk factors that are negatively associated with the prognosis of patients with thyroid cancer. The aim of the present study was to investigate the relationship between central lymph node metastasis (CLNM) and LLNM in patients with papillary thyroid carcinoma (PTC) with sonographically suspected LLNM, such as those without lymph node fine-needle aspiration (FNA) cytological results or negative FNA results at the time of diagnosis. The predictive ability of CLNM regarding LLNR was also investigated. The present study retrospectively reviewed the clinical data of 1,061 patients that were surgically treated for PTC and 128 patients with sonographically suspected lateral lymph nodes that received central lymph node dissection and lateral lymph node dissection at the Thyroid Department of The First Affiliated Hospital of Anhui Medical University (Hefei, China) from June 2019 to June 2021. In patients with suspicious ultrasonic images suggesting LLNM, a significant association between the central lymph node ratio (CLNR), the number of positive central lymph nodes and LLNM was demonstrated. Otherwise, there were no statistically significant differences between the CLNR in patients with PTC and patients with PTC without evidence of lateral cervical metastasis. However, the rate of LLNR increased significantly when the number of positive central lymph nodes was >3. In conclusion, the CLNR and the number of positive central lymph nodes could be used to predict LLNM in patients with PTC with sonographically suspect lateral lymph nodes, including those with no FNA cytological results or negative FNA results, which may potentially support physicians in making personalized clinical decisions.
颈部淋巴结转移是甲状腺癌的常见情况，术前侧方淋巴结转移（LLNM）和术后侧方淋巴结复发（LLNR）是两个独立的危险因素，与甲状腺癌患者的预后呈负相关。本研究的目的是调查甲状腺乳头状癌（PTC）患者中，超声怀疑有LLNM（如诊断时无淋巴结细针穿刺（FNA）细胞学结果或FNA结果为阴性）时，中央淋巴结转移（CLNM）与LLNM之间的关系。还研究了CLNM对LLNR的预测能力。本研究回顾性分析了2019年6月至2021年6月在安徽医科大学第一附属医院（中国合肥）甲状腺科接受手术治疗的1061例PTC患者以及128例超声怀疑有侧方淋巴结并接受中央淋巴结清扫和侧方淋巴结清扫的患者的临床资料。在超声图像可疑提示LLNM的患者中，中央淋巴结比率（CLNR）、中央阳性淋巴结数量与LLNM之间存在显著关联。否则，PTC患者与无侧颈部转移证据的PTC患者的CLNR之间无统计学显著差异。然而，当中央阳性淋巴结数量>3时，LLNR发生率显著增加。总之，CLNR和中央阳性淋巴结数量可用于预测超声怀疑有侧方淋巴结的PTC患者的LLNM，包括那些无FNA细胞学结果或FNA结果为阴性的患者，这可能有助于医生做出个性化的临床决策。
