Correlation between conventional ultrasound and contrast-enhanced ultrasound and lymph node metastasis of papillary thyroid carcinoma

doi:10.3969/j.issn.1006-7795.2019.06.002

Abstract

Abstract: Objective To evaluate the correlation between the characteristics of ultrasound and contrast-enhanced ultrasound (CEUS) and lymph node metastasis of papillary thyroid carcinoma (PTC). Method A retrospective analysis was conducted on the patients who underwent surgery in the PLA General Hospital in 2018 due to suspicious single thyroid nodule. Routine two-dimensional ultrasound examination and CEUS examination were performed before surgery. Patients' age, gender, conventional ultrasound and CEUS characteristics of the lesions were recorded. The gold standard was based on the surgical pathological result. PTC nodules were divided into two groups according to the lymph node metastases (LNM) or not. Univariate and multivariate analyses were performed to compare the differences between ultrasonographic, CEUS characteristics and lymph node metastasis. Result A total of 293 nodules were enrolled in this study, which includes 134 nodules with LNM while 159 nodules without LNM. Univariate analyses shows statistically significant differences about patients' ages, gender, the maximum diameter of PTC nodule, echogenicity of the nodule, taller than wide, Color Doppler flow imaging(CDFI), capsule extension on ultrasound, ultrasound scanning suspicious LNM, enhancement pattern, homogeneity, wash-out speed, capsule extension on CEUS between the two groups. Logistic regression revealed that risk factors of cervical lymph node metastasis (CLNM) included young patients (P=0.008), male gender (P<0.001), large PTC nodule (P=0.017),rich blood flow in CDFI (P=0.034)and capsule extension on CEUS (P=0.033). Conclusion Some characteristics of ultrasound and CEUS are correlated with LNM of PTC, which may play a role in the prediction of LNM of PTC.

Key words: papillary thyroid carcinoma, contrast enhanced ultrasound, lymph node metastasis

CLC Number:

Jiang Bo, Luo Yukun, Zhang Yan, Tian Xiaoqi, Zhang Ying, Xie Fang, Song Qing, Tang Jie. Correlation between conventional ultrasound and contrast-enhanced ultrasound and lymph node metastasis of papillary thyroid carcinoma[J]. Journal of Capital Medical University, 2019, 40(6): 818-823.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2019.06.002

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2019/V40/I6/818

References

[1] Welch H G, Doherty G M. Saving thyroids-overtreatment of small papillary cancers[J]. N Engl J Med, 2018, 379(4):310-312.
[2] Lee Y C, Na S Y, Park G C, et al. Occult lymph node metastasis and risk of regional recurrence in papillary thyroid cancer after bilateral prophylactic central neck dissection:A multi-institutional study[J]. Surgery, 2017, 161(2):465-471.
[3] Zhan J, Diao X, Chen Y, et al. Predicting cervical lymph node metastasis in patients with papillary thyroid cancer (PTC)-Why contrast-enhanced ultrasound (CEUS) was performed before thyroidectomy[J]. Clin Hemorheol Microcirc, 2019,72(1):61-73.
[4] Hwang H S, Orloff L A. Efficacy of preoperative neck ultrasound in the detection of cervical lymph node metastasis from thyroid cancer[J]. Laryngoscope, 2011, 121(3):487-491.
[5] 张艳, 罗渝昆, 张明博, 等. 对比增强超声与常规超声在判断甲状腺乳头状癌颈部淋巴转移中的意义[J]. 中国医学科学院学报, 2017, 39(2):177-182.
[6] Lee J H, Shin H J, Yoon J H, et al. Predicting lymph node metastasis in patients with papillary thyroid carcinoma by vascular index on power Doppler ultrasound[J]. Head Neck, 2017, 39(2):334-340.
[7] Tessler F N, Middleton W D, Grant E G, et al. ACR thyroid imaging, reporting and data system (TI-RADS):White Paper of the ACR TI-RADS committee[J]. J Am Coll Radiol, 2017,14(5):587-595.
[8] Rago T, Vitti P, Chiovato L, et al. Role of conventional ultrasonography and color flow-doppler sonography in predicting malignancy in ‘cold’ thyroid nodules[J]. Eur J Endocrinol, 1998, 138(1):41-46.
[9] Creach K M, Gillanders W E, Siegel B A, et al. Management of cervical nodal metastasis detected on I-131 scintigraphy after initial surgery of well-differentiated thyroid carcinoma[J]. Surgery, 2010, 148(6):1198-1204.
[10] Sipos J A. Advances in ultrasound for the diagnosis and management of thyroid cancer[J]. Thyroid, 2009, 19(12):1363-1372.
[11] Zhang Y, Luo Y K, Zhang M B, et al. Values of ultrasound features and MMP-9 of papillary thyroid carcinoma in predicting cervical lymph node metastases[J]. Sci Rep, 2017, 7(1):6670.
[12] Shin H J, Kim E K, Moon H J, et al. Can increased tumoral vascularity be a quantitative predicting factor of lymph node metastasis in papillary thyroid microcarcinoma?[J]. Endocrine, 2014, 47(1):273-282.
[13] Wang M, Wu W D, Chen G M, et al. Could tumor size be A predictor for papillary thyroid microcarcinoma:a retrospective cohort study[J]. Asian Pac J Cancer Prev, 2015, 16(18):8625-8628.
[14] Nam S Y, Shin J H, Han B K. et al. Preoperative ultrasonographic features of papillary thyroid carcinoma predict biological behavior[J]. J Clin Endocrinol Metab, 2013,98(4):1476-1482.
[15] Stabenow E, Tavares M R, Ab'Saber A M, et al. Angiogenesis as an indicator of metastatic potential in papillary thyroid carcinoma[J]. Clinics (Sao Paulo, Brazil), 2005, 60(3):233-240.
[16] Zhan W W, Zhou P, Zhou J Q, et al. Differences in sonographic features of papillary thyroid carcinoma between neck lymph node metastatic and nonmetastatic groups[J]. J Ultrasound Med, 2012, 31(6):915-920.
[17] Huang X Q, He W S, Zhang H Q, et al. Relationship between expression of vascular endothelial growth factor and cervical lymph node metastasis in papillary thyroid cancer:A meta-analysis[J]. J Huazhong Univ Sci Technolog Med Sci, 2017, 37(5):661-666.
[18] Meng X Y, Zhang Q, LI Q, et al. Immunohistochemical levels of cyclo-oxygenase-2, matrix metalloproteinase-9 and vascular endothelial growth factor in papillary thyroid carcinoma and their clinicopathological correlations[J]. J Int Med Res, 2014, 42(3):619-627.
[19] 彭华童, 吴文艺,张丽婷,等.SIRT1沉默对人甲状腺乳头状癌细胞株TPC-1生物学功能的影响[J].中国医科大学学报,2018,47(4):321-328.
[20] 倪静, 乐岭,王永,等.高糖对甲状腺乳头状癌K1细胞增殖及Nrf2表达和转位影响[J].中华肿瘤防治杂志,2017,24(19):1335-1341.
[21] 刘琪, 魏象东,冀凯伦,等.HOXB9基因对甲状腺乳头状癌细胞增殖与侵袭转移能力影响研究[J].中华肿瘤防治杂志,2018,25(9):628-633.
[22] Wei X, Li Y, Zhang S, et al. Prediction of thyroid extracapsular extension with cervical lymph node metastases (ECE-LN) by CEUS and BRAF expression in papillary thyroid carcinoma[J]. Tumour Biol, 2014, 35(9):8559-8564.