Correlation of routine ultrasound features and BRAFV600E gene to the cervical lymph node metastasis of thyroid papillary carcinoma / 解放军医学杂志

ABSTRACT

Objective: To investigate the correlation of routine ultrasound features and BRAFV600E gene to the cervical lymph node metastasis (CLNM) of thyroid papillary carcinoma (PTC). Methods: A hundred and seven patients with thyroid papillary carcinoma who underwent thyroid gland resection and cervical lymph node dissection in the First Medical Center of Chinese PLA General Hospital from January to December 2018 were recruited as study subjects, including 56 patients in the metastatic group and 51 patients in the non-metastatic group. Ultrasound examination and BRFV600E gene detection were performed, and the indicators obtained were compared between the two groups including gender, age, focus position (upper middle or inferior), close to the capsule or to the isthmus, focus located in the lef or right lobes, single or multiple, maximum diameter, aspect ratio, boundary, shape, internal echo, internal components, peripheral halos, calcification, microcalcification, color Doppler features, Hashimoto's disease, and BRFV600E gene mutation. Logistic regression analysis was conducted for gender, age, close to the capsule or to the isthmus, maximum diameter, shape, calcification, microcalcification, color Doppler features, Hashimoto's disease, and BRAFV600E gene mutation to establish a predictive model of cervical lymph node metastasis in patients with thyroid papillary carcinoma, and the predictive efficacy of the model was evaluated. Results: The results compared between the two groups showed that statistically significant differences existed in gender, age, maximum diameter of the lesion, close to capsule, close to isthmus, shape, acoustic halo, calcification and microcalcification (P<0.05). Logistic multivariate regression analysis showed that gender (OR=4.197), age (OR=4.895) and maximum diameter (OR=3.636) were risk factors for cervical lymph node metastasis in patients with thyroid papillary carcinoma (P<0.05). The prediction model established by logistic regression analysis was logistic (P)=-21.957+1.434×gender+1.588×age+1.291×maximum diameter. The efficiency test results of the prediction model showed that the sensitivity and specificity were up to 75.00% and 72.55% respectively. Conclusions: It is preliminarily confrmed that BRFV600E gene mutation is not correlated with cervical lymph node metastasis in patients with thyroid papillary carcinoma. For male patients aged less than 55 years old, the risk of cervical lymph node metastasis should be on guard when the maximum diameter of the carcinoma is large than 10 mm.