Predictive value of ultrasonography in metastasis of cervical lymph nodes in patients with papillary thyroid carcinoma

Abstract

Objective To investigate the value of ultrasonography (US) in predicting the cervical metastatic lymph nodes (MLN) in papillary thyroid carcinoma (PTC). Methods Preoperative ultrasonographic data of 65 PTC with MLN confirmed by surgery and pathology were studied retrospectively. These sonographic features such as the size of lymph nodes, the distribution area, boundary, aspect ratio, the shape, internal calcification and the internal blood flow were observed. Results (1) In diagnosis of MLN by US, the accurate rate, sensitivity, specificity, positive predictive value and negative predictive value were separately 90.65%, 83.50%, 88.61%, 92.71% and 88.68%. There was no significant difference between preoperative US in predicting MLN with PTC and postoperative pathological diagnosis (χ2=0.316, P>0.05), but the internal consistency of the two methods was poor, Kappa value=0.023, P>0.05. (2) There was statistically significant difference in eccentricity or loss of an echogenic fatty hilum, internal microcalcification, the aspect ratio, rich or irregular internal blood flow, internal cystic change and moderate echo mass between MLN and non-MLN (χ2=153.582, 43.793, 38.996, 65.530, 22.205 and 37.611 respectively, all P 0.05). (3) The predominant sites of metastasis were Ⅳ region and Ⅵ region, while the most was the central region (Ⅵ region, 73.8%), and the predominant site of non-metastasis was the lateral neck region (Ⅰ region, Ⅴ region), both with the statistically significant difference (χ2=12.493, 44.320, 7.444, 12.976, all P<0.05). Conclusion US has the important value in predicting MLN with PTC. Key words: Ultrasonography; Thyroid carcinoma; Cervical lymph node metastasis