期刊
ULTRASOUND IN MEDICINE AND BIOLOGY
卷 44, 期 11, 页码 2296-2306出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ultrasmedbio.2018.06.020
关键词
Papillary thyroid carcinoma; CK19; Human bone marrow endothelial cell-1; Galectin-3; Thyroid peroxidase; BRAF(V600E )mutation; Central cervical lymph node metastases
资金
- National Natural Scientific Foundation of China [81725008, 81601502, 81472501, 81401417]
- Shanghai Hospital Development Center [SHDC22015005, SHDC12014229]
- Science and Technology Commission of Shanghai Municipality [16411971100, 15411969000, 14441900900]
The study was aimed at evaluating the correlation between central cervical lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC) patients and ultrasound (US) features, immunohistochemical factors and BRAF(V600E) mutation. A total of 225 consecutive patients (225 PTCs) who had undergone surgery were included. All PTCs were pre-operatively analysed by US with respect to size, components, echogenicity, shape, margins, microcalcification, multiple cancers or not, internal vascularity and capsule contact or involvement. The presence of four immunohistochemical factors, including cytokeratin 19, human bone marrow endothelial cell 1, galectin-3 and thyroid peroxidase, and BRAF(V600E) mutation was also evaluated. Univariate and multivariate analyses were performed to identify the risk factors for central CLNM, and a risk model was established. Pathologically, 44% (99/225) of the PTCs had central CLNMs. Multivariate analysis revealed that size <= 10 mm, microcalcification, internal vascularity, capsule contact or involvement and BRAF(V600E) mutation were independent risk factors for central CLNM. The risk score for central CLNM was calculated as follows: risk score = 1.5 x (if lesion size <= 10 mm) + 1.9 x (if microcalcification) + 0.8 x (if internal flow) + 3.0 x (if capsule contact or involvement) + 1.5 x (if BRAF(V600E) mutation). The rating result was divided into six stages, and the relevant risk rates of central CLNM were 0% (0/1), 0% (0/22), 7.4% (4/54), 48.6% (34/70), 71.2% (42/59) and 100% (19/19), respectively. In conclusion, PTC <= 10 mm, microcalcification, internal vascularity, capsule contact or involvement and BRAF(V600E) mutation are risk factors for central CLNM. The risk model may be useful in treatment planning and management of patients with PTCs. (C) 2018 World Federation for Ultrasound in Medicine & Biology. All rights reserved.
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