Clinical features and imaging examination assessment of cervical lymph nodes for thyroid carcinoma

• Published in: BMC cancer Vol. 23; no. 1; pp. 1225 - 9
• Main Authors: Wei, Bei, Yao, Jincao, Peng, Chanjuan, Zhao, Shanshan, Wang, Hui, Wang, Liping, Zhu, Xi, Kong, Yuting, Chen, Liyu, Xu, Dong
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.12.2023; BioMed Central; BMC
• Subjects: Airway management; Biopsy; Cancer; Carcinoma; Carcinoma, Papillary - pathology; Cervical carcinoma; Cervical lymph node Metastasis; Clinical characteristics; Computed tomography; CT imaging; Development and progression; Diagnosis; Diagnostic imaging; Dissection; Evaluation; Female; Health aspects; Hospitals; Humans; Lymph nodes; Lymph Nodes - pathology; Lymphatic Metastasis - diagnostic imaging; Lymphatic Metastasis - pathology; Lymphatic system; Male; Metastases; Metastasis; Methods; Middle Aged; Nodules; Retrospective Studies; Risk Factors; Thoracic surgery; Thyroid cancer; Thyroid Cancer, Papillary - pathology; Thyroid carcinoma; Thyroid Neoplasms - complications; Thyroid Neoplasms - diagnostic imaging; Thyroid Neoplasms - surgery; Thyroidectomy; Thyroiditis; Tomography; Tumors; Ultrasonic imaging; Ultrasound; China; United States > US; Clinical characteristics; CT; Cervical lymph node Metastasis; Ultrasound; Thyroid carcinoma
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-023-11721-5

The purpose of this study is to investigate the relationship between clinical characteristics and cervical lymph node metastasis (LNM) in patients with thyroid carcinoma, as well as estimate the preoperative diagnosis values of ultrasound (US) and contrast enhanced computed tomography (CECT) examinations on the neck for detection of cervical LNM in thyroid carcinoma. A retrospective analysis of 3 026 patients with surgically proven thyroid carcinoma was conducted. Patients' clinical characteristics, including gender, age, tumor size, bilateral lesions, multifocality, adenomatous nodules, Hashimoto's thyroiditis (HT), and extrathyroidal extension, were collected to explore their association with cervical LNM in thyroid carcinoma. Preoperative assessments for central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) were conducted through US and CECT. The diagnostic value of US, CECT and US combined with CECT for detection of LNM located in various cervical compartments was estimated based on the pathological results. The risk of cervical LNM was higher in thyroid cancer patients who were male, age < 55 years old, tumor size > 10 mm, bilateral lesions, and extrathyroidal extension, while multifocality, adenomatous nodules and HT had no significant effect on LNM. US, CECT and US combined with CECT all had a higher sensitivity to LLNM (93.1%, 57.8%, 95.4%) than to CLNM (32.3%, 29.0%, 43.4%). US and CECT had a high specificity to both CLNM and LLNM (94.3-97.8%). Preoperative clinical characteristics and imaging examinations on patients with thyroid carcinoma are crucial to the evaluation of cervical lymph nodes and conducive to individualizing surgical treatments by clinicians. US combined with CECT are superior to single US or CECT alone in detection of CLNM and LLNM.