Tumor location and lateral lymph node metastasis in papillary thyroid microcarcinoma / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To evaluate tumor location as a factor predicting lateral lymph node metastasis(LLNM) and to assess the accuracy of ultrasonography(US) in the diagnosis of LLNM.METHODS: The clinicopathological data of 134 patients with thyroid microcarcinoma admitted between January 2014 and December 2015 in Tianjin Medical University Cancer Hospital were collected,and the relationship between the location of cancer foci and lateral cervical lymph node metastasis was analyzed according to the ultrasonic localization and grouping.RESULTS: The incidence rates of lymph node metastasis in levels Ⅱ,Ⅲ,Ⅳ,Ⅴ were 30.6, 50.7, 57.5 and 11.3%, respectively. Tumors located in the superior/middle were prone to metastasize to the lateral lymph nodes than those located in the inferior portion(89.7% vs. 75.7%,P=0.038). Cases with exterior locations were more likely to have lateral cervical lymph node metastasis compared with those cases with interior, respectively(93.7% vs.81.4%,P=0.049). The sensitivity values for US for the prediction of LLNM in levels Ⅱ,Ⅲ,Ⅳ,Ⅴ were 43.9%, 85.3%, 85.7% and 14.3%, and the corresponding specificity values were 91.4%, 57.6%, 35.1% and 99.1%. The ultrasonographic prediction of lymph node metastasis in Ⅲ and Ⅳ was highly sensitive,and the specificity in Ⅱ and Ⅴ was high.CONCLUSION: The localization of primary carcinoma is correlated with lateral lymph node metastasis in papillary thyroid microcarcinoma,and ultrasound could provide a basis for clinical determination of the dissection range of lateral lymph node.