Diagnostic value of ultrasound and clinical pathological features for Delphian lymph node metastasis in patients with papillary thyroid carcinoma
Objective To explore the diagnostic value of ultrasound and clinical pathological features for Delphian lymph node(DLN)metastasis in patients with papillary thyroid carcinoma(PTC).Methods One hundred and twenty patients with PTC treated at Tongchuan People's Hospital from February 2021 to August 2023 were selected as the study objects,including 36 males and 84 females who were(43.69±6.85)years old.They were divided into a metastatic group and a control group(without metastasis)based on the presence or absence of DLN metastasis.Both groups underwent ultrasound examination.The information on their ultrasound and clinical pathological features was collected.The factors affecting DLN metastasis in the patients were analyzed.The diagnostic efficacy of ultrasound and clinical pathological features for DLN metastasis in the patients was evaluated using the receiver operating characteristic curve(ROC).t test,rank sum test,and x2 test were applied.Results A total of 145 lesions were detected in the 120 patients.There were 93 lesions in the patients without DLN metastasis and 52 lesions in the patients with DLN metastasis.There statistical differences between the metastatic group and the control group in terms of age[＞45 years:30.56％(11/36)vs.54.76％(46/84)],tumor location[isthmus and upper lobe 1/3:67.31％(35/52)vs.21.51％(20/93)],longitudinal diameter[≥10 mm:59.62％(31/52)vs.38.71％(36/93)],aspect ratio[≥1:55.77％(29/52)vs.32.26％(36/93)],multiple lesions[41.67％(21/36)vs.20.24％(67/84)],capsule invasion[63.46％(33/52)vs.40.86％(38/93)],and lymph node metastasis in the non-central area of the larynx[53.85％(24/52)vs.31.18％(64/93)](x2=5.921,29.718,5.864,7.639,5.917,6.818,and 7.180;all P＜0.05).The results of logistic regression analysis showed that the risk factors for DLN metastasis in the patients with PTC were tumors located in the isthmus and upper one-third of the lateral lobe,aspect ratio≥1,capsule invasion,and lymph node metastasis in the non-central area of the larynx(OR=3.267,7.576,3.130,and 8.306;all P＜0.05).The ROC displayed the area under the curve(AUC),sensitivity,and specificity of the combination were 0.775,67.31％,and 78.49％,respectively.The AUC's of tumor location,aspect ratio,capsule invasion,and lymph node metastasis in the non-central area of the larynx were 0.729,0.618,0.613,and 0.613(all P＜0.05).Conclusions Among the ultrasound and clinical pathological features of patients with PTC,the presence of tumors in the isthmus and upper 1/3 of the lateral lobe,aspect ratio ≥ 1,capsule invasion,and lymph node metastasis in the non-central area of the larynx are risk factors for DLN metastasis;their combination has high diagnostic value.
Thyroid cancerLymph node metastasisUltrasoundClinical pathological featuresDiagnostic value
万方数据
维普
