Prediction of central lymph node metastasis in papillary thyroid microcarcinoma according to clinicopathologic factors and thyroid nodule sonographic features: a case-control study
| Autor: | Yi-Han Sun, Ouchen Wang, Ye-Feng Cai, Danrong Ye, Xiaohua Zhang, Wen-Xu Jin, Xiaofen Zhou |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis business.industry Thyroid Case-control study Papillary Thyroid Microcarcinoma 030209 endocrinology & metabolism Nodule (medicine) Central lymph 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Oncology Central Lymph Node Dissection Cancer Management and Research 030220 oncology & carcinogenesis Medicine Radiology Lymph medicine.symptom business |
| Zdroj: | Cancer Management and Research. 10:3237-3243 |
| ISSN: | 1179-1322 |
| DOI: | 10.2147/cmar.s169741 |
| Popis: | Wen-Xu Jin,1,2,* Dan-Rong Ye,2,* Yi-Han Sun,2,* Xiao-Fen Zhou,2 Ou-Chen Wang,2 Xiao-Hua Zhang,2 Ye-Feng Cai2 1Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325000, China; 2Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325000, China *These authors contributed equally to this work Background: Preoperative diagnosis of central lymph node metastasis (CLNM) poses to be a challenge in clinical node-negative papillary thyroid microcarcinoma (PTMC). This research work aims at investigating the association existing between BRAF mutation, clinicopathological factors, ultrasound characteristics, and CLNM, in addition to establishing a predictive model for CLNM in PTMC.Materials and methods: The study included 673 PTMC patients, already undergone total thyroidectomy or lobectomy with prophylactic central lymph node dissection. The predictor factors were identified through univariate and multivariate analyses. The support vector machine was put to use to develop statistical models, which could predict CLNM on the basis of independent predictors.Results: Tumor size (>5 mm), lower location, no well-defined margin, contact of >25% with the adjacent capsule, display of enlarged lymph nodes, and BRAF mutation were independent predictors of CLNM. Through the use of the predictive model, 79.6% of the patients were classified accurately, the sensitivity and specificity amounted to be 85.1% and 75.8%, respectively, and the positive predictive value and negative predictive value stood at 71.6% and 87.6%, respectively.Conclusions: We established a predictive model in order to predict CLNM preoperatively in PTMC when preoperative diagnosis of CLNM was not clear. Keywords: papillary thyroid microcarcinoma, central lymph node, predictive factor, support vector machine |
| Databáze: | OpenAIRE |
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