ABSTRACT
Objective To investigate the predictive factors for central lymph node metastasis (CLNM) in papillary thyroid microcarcinoma(PTMC).Methods A retrospective study including 2511 cases of PTMC admitted from Jan.2013 to Jan.2016 were enrolled in our study.Chi-square test was used in univariate analysis.Logistic regression analysis was applied for multivariate analysis.The relation between age,sex,tumor size,multifocality,thyroidal extension,nodular goiter and central lymph node metastasis is analyzed.Results Univariate analysis showed that age,sex,tumor size,multifocality,thyroidal extension and nodular goiter had statistical significance.Age less than 45(P＜0.001,x2=17.442);Male gender(P＜0.001,x2=17.029);Tumor size less than 5 mm (P＜0.001,x2=70.164.);Extrathyroid extension factor (P＜0.001,x2=63.197);Nodular hyperplasia factor (P=0.017,x2=5.611).Multivariate analysis showed there was a significant relationship between multifocality and the central lymph node positivity.The odds ratio (OR) was 1.587 in patients with tumor foci ≥2(P＜0.001).While OR increased sharply near to 3 in patients withtumor foci ≥3(OR=2.730).Tumor size(OR=1.926);Extrathyroid extension(OR=1.606).Conclusions Multifocalty,tumor size and thyroidal extension are the main predicative factors for central lymph node metastasis in PTMC.Among them,tumor foci ≥ 3 is an important predictor.Besides the conventional factors such as tumor size,thyroidal extension etc,multifocalty should also be taken into consideration.
ABSTRACT
Objective To investigate the expression level and clinical significance of long non-coding RNA(LncRNA) growth arrest specific gene-antisense 1(GAS8-AS1) in papillary thyroid microcarcinoma(PTMC) patients. Methods We investigated the expression profile of GAS8-AS1 in tissue samples of patients with PTMC as well as nodular goiter(NG) by quantitative real-time polymerase chain reaction(RT-qPCR). Results GAS8-AS1 in cancer tissue was down-regulated in PTMC patients compared with adjacent thyroid tissue and NG samples(P<0.05). Lower level of GAS8-AS1 was also correlated with central cervical lymph node metastasis(CLNM, P<0.05). The area under the ROC curve for GAS8-AS1 was up to 0.717 3 in CLNM prediction(P<0.05). Conclusion GAS8-AS1 may act as a potential biomarker for PTC diagnosis and CLNM prediction.
ABSTRACT
Objective To compare the clinical and sonographic characteristics of aggressive and nonaggressive papillary thyroid microcarcinomas(PTMC)in order to improve the preoperative predictive value of aggressive PTMC.Methods A total of 309 patients with PTMC from January 2014 to December 2016 were included in this study.Patients with lymphatic metastasis,extrathyroidal invasion,reccurence, distant metastasis and death were classified into aggressive PTMC group,and patients without above characteristics were classified into nonaggressive group.Clinical and sonographic features were reviewed and compared between the two groups.Results Among the 309 patients,76 cases(24.6%)were aggressive PTMC,and 233 cases(75.4%)were nonaggressive.Patients were younger and larger cancerous nodules, microcalcification,capsular inconnection and multifocality were seen more frequently in aggressive PTMC group compared with nonaggressive group.The best cut-off value of age and diameter were 44.5 years and 0.66 cm respectively.Advanced age was the protective factor and larger tumor size and multifocality were independent risk factors for PTMC aggressiveness.The capsular invasion was related with the lateral cervical lymph node metastasis while other features were not.Conclusions Extra attention should be paid to patients with age<44.5 years,tumor size>0.66 cm and multifocal cancerous nodules because their PTMCs are more likely to be aggressive.Thyroid capsule adjacent to the cancerous nodule should be observed carefully.If there is interruption in the capsule,lateral cervical lymph nodes should be carefully examed.