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Clinical and sonographic features for the preoperative prediction of lymph nodes posterior to the right recurrent laryngeal nerve metastasis in patients with papillary thyroid carcinoma

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Abstract

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.

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Funding

This study is funded by National Key Research and Development Project (Grant No. 2017YFC0113805).

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Authors and Affiliations

  1. Department of Ultrasound, Peking Union Medical College Hospital, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China

    M. Zou, Y. H. Wang, Y. F. Dong, X. J. Lai & J. C. Li

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  1. M. Zou
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  2. Y. H. Wang
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  3. Y. F. Dong
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  4. X. J. Lai
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  5. J. C. Li
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Correspondence to X. J. Lai or J. C. Li.

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The authors declare that they have no conflicts of interest.

Ethics approval

This study was approved by the Internal Review Board of Peking Union Medical College Hospital. Investigations involving human participants in this study were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was not required because of the retrospective character of the study.

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Zou, M., Wang, Y.H., Dong, Y.F. et al. Clinical and sonographic features for the preoperative prediction of lymph nodes posterior to the right recurrent laryngeal nerve metastasis in patients with papillary thyroid carcinoma. J Endocrinol Invest 43, 1511–1517 (2020). https://doi.org/10.1007/s40618-020-01238-0

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  • DOI: https://doi.org/10.1007/s40618-020-01238-0

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