Objective: To demonstrate the ultrasonographic features of papillary thyroid carcinoma (PTC) in predicting associated cervical lymph nodes metastasis (LNM).
Methods: A total of 136 patients diagnosed with PTC in Beijing Tongren Hospital between January 2014 and September 2014 were enrolled.Of 136 cases, forty patients were confirmed with cervical lymph node metastasis.Seven were males, 33 were females, aged from 18 to 65 years old, mean age was (39.6±10.3) years .The remaining 96 were reported without lymph node metastasis.Twenty-one were males, 75 were females, aged from 23 to 86 years old, mean age was (47.7±12.8) years.Medical record was reviewed for demographic characteristics and pathological findings.The ultrasonographic features of each case were evaluated retrospectively.The difference of ultrasonographic features between the patients with and without LNM was examined.
Results: There were 178 PTCs confirmed with pathology, 159 lesions (89.3%) were detected by ultrasonography, the remaining 19 lesions (10.7%) were under-detected.Of 136 patients with PTC, 40 cases (40/136, 29.4%) were confirmed with cervical LNM, while the remaining 96 cases (96/136, 70.6%) were determined without cervical LNM.PTC with cervical LNM was more frequently seen in the patients who were younger (P=0.000 5) and presenting with multifocal tumors (P=0.014 6). Ultrasonographic features of PTC which significantly associated with LNM were ill-defined margins (P=0.018), solid appearance (P=0.003), and presence of calcification (P=0.000). Of 40 cases with LNM, central cervical LNM was seen in 32 cases (80%), 72.5% of whom appeared as unilateral distribution.
Conclusions: Patients diagnosed with PTC with younger age and identified with multiple foci of tumors at the time of diagnosis are in an increased risk of associated cervical LNM.Ultrasonographic features of ill-defined margins, solid appearance and calcification in PTC are significant predictors of LNM.