Prediction of central compartment lymph node metastasis in papillary thyroid microcarcinoma
| Autor: | Chengze Chen, Yinlong Yang, Jiachun Jiang, Zimiao Chen, Guilong Guo, Xiaohua Zhang, Yizuo Chen, Tingting Ye, Langping Jin |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Endocrinology Diabetes and Metabolism Central compartment Papillary Thyroid Microcarcinoma Lymph node metastasis Young Adult Endocrinology Risk Factors Internal medicine Humans Medicine Thyroid Neoplasms Aged Retrospective Studies business.industry Retrospective cohort study Middle Aged Lateral neck Carcinoma Papillary BRAF V600E Lymphatic Metastasis Neck Dissection Female Ultrasonography business Lymphocytic Thyroiditis |
| Zdroj: | Clinical Endocrinology. 81:282-288 |
| ISSN: | 0300-0664 |
| Popis: | We aimed to determine the predictive factors for central compartment lymph node metastasis (LNM) in papillary thyroid microcarcinoma (PTMC).We undertook a retrospective study of 291 patients treated for PTMC. The following criteria were assessed to predict the presence of central compartment LNM: sex, age, tumour multifocality, tumour size, tumour bilaterality, extracapsular spread (ECS), lateral neck LNM, coexistence of chronic lymphocytic thyroiditis, BRAF(V) (600E) mutation and ultrasonography (US) features. Univariate and multivariate analyses were performed to identify clinicopathological characteristics and US findings in predicting central compartment LNM from PTMC.The central compartment LNM affected 133 (45.7%) of 291 patients. With use of univariate and multivariate analyses, male gender (OR 2.020; P = 0.039), tumour size (5 mm) (OR 3.687; P = 0.015), ESC (OR 2.330; P = 0.044), lateral LNM (OR 15.075; P = 0.000) and BRAF(V) (600E) mutation (OR 2.464; P = 0.000) were independently correlated with central compartment LNM. Age, tumour multifocality, tumour bilaterality, coexistence of chronic lymphocytic thyroiditis and US characteristics were not significantly related to the presence of central compartment LNM. We have also developed a nomogram to predict the probability of central compartment LNM for an individual patient. The sensitivity was 71.9% and specificity was 70.3%, with an under the receiver operating characteristic (ROC) curve of 0.772.A prophylactic neck dissection of the central compartment should be considered particularly in PTMC patients with male gender, a5 mm tumour size, ECS of the tumours, lateral LNM and positive BRAF(V) (600E) mutation. |
| Databáze: | OpenAIRE |
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