Objective

To evaluate clinical and sonographic features predictive of lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in patients diagnosed with papillary thyroid carcinoma (PTC).

Methods

We retrospectively reviewed the clinical records and ultrasound (US) images of 479 consecutive PTC patients who received total thyroidectomy or right lobectomy with central neck dissection (CND) between October 2017 and October 2019. Univariate and multivariate analyses were performed to identify clinical and sonographic features associated with LN-prRLN metastasis. Receiver operating characteristic (ROC) analysis was applied to evaluate the efficacy of clinical and sonographic features in the preoperative prediction of LN-prRLN metastasis.

Results

Overall, 127 (26.5%) patients had LN-prRLN metastasis. Multivariate logistic regression analysis showed that age < 45 years (p = 0.005; OR 2.155; 95% CI 1.262–3.683), male sex (p = 0.043; OR 1.657; 95% CI 1.016–2.704), tumor diameter > 1 cm (p = 0.042; OR 1.702; 95% CI 1.019–2.842), microcalcifications (p = 0.022; OR 1.980; 95% CI 1.104–3.551), and US-detected lateral compartment lymph node (LLN) metastasis (p = 0.001; OR 2.578; 95% CI 1.500–4.430) were independent risk factors for LN-prRLN metastasis. ROC analysis revealed that the multivariate logistic regression model had good accuracy in predicting LN-prRLN metastasis, with an area under the ROC curve of 0.758.

Conclusions

Age less than 45 years, male sex, tumor diameter larger than 1 cm, microcalcifications, and US-detected LLN metastasis may preoperatively predict LN-prRLN metastasis.

中文翻译：

---

甲状腺乳头状癌患者术前预测右喉返神经转移后淋巴结的临床和超声特征。

目的

为了评估诊断为乳头状甲状腺癌（PTC）的患者右喉返神经（LN-prRLN）转移后淋巴结的临床和超声特征。

方法

我们回顾性研究了2017年10月至2019年10月之间接受全甲状腺切除术或右肺叶切除术并进行了中央颈淋巴结清扫术（CND）的479例连续PTC患者的临床记录和超声图像。与LN-prRLN转移有关。接受者操作特征（ROC）分析用于评估临床和超声特征在术前预测LN-prRLN转移的疗效。

结果

总体而言，有127名（26.5％）患者发生了LN-prRLN转移。多元logistic回归分析显示年龄<45岁（p  = 0.005; OR 2.155; 95％CI 1.262–3.683），男性（p  = 0.043; OR 1.657; 95％CI 1.016–2.704），肿瘤直径> 1 cm（p  = 0.042； OR 1.702； 95％CI 1.019-2.842），微钙化（p  = 0.022； OR 1.980； 95％CI 1.104-3.551）和US检测到的外侧腔淋巴结转移（p  = 0.001； OR 2.578； 95％CI 1.500-4.430）是LN-prRLN转移的独立危险因素。ROC分析显示，多元逻辑回归模型在预测LN-prRLN转移方面具有良好的准确性，ROC曲线下的面积为0.758。

结论

年龄小于45岁，男性，肿瘤直径大于1厘米，微钙化和US检测到的LLN转移可在术前预测LN-prRLN转移。