Clinical features and recurrence factors of locally advanced differentiated thyroid cancer with laryngeal nerve involved
Objective To investigate the clinical characteristics of ultrasound[peak systolic flow velocity(PSV),resistance index(RI)],objective acoustic indicators,and the risk factors of postoperative recurrence in patients with locally advanced differentiated thyroid cancer(DTC)involving laryngeal nerve.Methods The data of 80 patients with locally advanced DTC involving laryngeal nerve treated in our hospital from Mar 2020 to Mar 2022 were retrospectively selected,and the data of 80 patients with involving locally advanced DTC without involving laryngeal nerve were selected,and the ultrasound and objective acoustic indicators were compared.All patients were treated with radical thyroidectomy and followed up for 24 months.80 patients with locally advanced DTC involving laryngeal nerve were divided into recurrence group and non-recurrence group according to recurrence or not.The risk factors of postoperative recurrence were analyzed by univariate and binary Logistic regression.Results Ultrasound indicators showed that PSV and RI in patients with locally advanced DTC involving laryngeal nerve were significantly higher than those in patients without laryngeal nerve involved.Comparison of objective acoustic indicators showed that F0 in male and female patients with laryngeal nerve involved group were lower than that in the control group,while Jitter and Shimmer were both higher in laryngeal nerve involved group.The MPT of laryngeal nerve involved group was significantly shorter.The differences were statistically significant(P<0.05).During the follow-up period,all patients survived,and recurrence occurred in 9 patients.Binary Logistic regression analysis showed that age,tumor diameter,vocal cord paralysis before surgery,laryngotracheal and esophageal invasion,and lymph node metastasis before surgery were independently correlated with postoperative recurrence(P<0.05).Conclusion Age≥55-year old,tumor diameter≥4cm,lymph node metastasis before sugery,laryngotracheal and esophageal invasion,and vocal cord paralysis are risk factors for postoperative recurrence in locally advanced DTC patients with laryngeal nerve involved.Preoperative ultrasound and objective acoustic indicators can provide important reference information for evaluating laryngeal nerve function.
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