Analysis Of The Correlation Between Ultrasonic Signs Of Papillary Thyroid Carcinoma And Lymph Node Metastasis

Objective(s):Explore basing on the clinical data and the ultrasonographic features of pathologically confirmed papillary thyroid carcinoma patients,analyze the correlation between them and lymph node metastasis.So as to improve the accuracy of ultrasonography for cervical lymph node metastasis,and to provide more reliable basis to surgeon before the surgery of cervical lymph nodes in thyroid cancer.Methods:Continuously and retrospective collecting the clinical data(gender and age)and the ultrasonographic features(including the number,size,boundary,aspect ratio,echo,microcalcifications,ultrasonic attenuation and blood flow of lesions)of pathologically confirmed 200 papillary thyroid carcinoma patients of The Third Affiliated Hospital of the Medical University from June 2018 to June 2020.A total of 258 nodules in 200 cases were divided into metastasis group and non-metastasis group which was basing on pathological result that whether the cervical lymph node metastasis occurred.Statistically analyzing 200 cases’clinical data(gender and age)and ultrasonic features of cancer nodule(including the number,size,boundary,aspect ratio,echo,microcalcifications,ultrasonic attenuation and blood flow of lesions).Using chi-square test for univariate analysis to obtain the predictive signs with statistically significant differences(P<0.05),and using the logistic regression multivariate analysis(P<0.05)to screen the risk factors between predictive signs and lymph node metastasis.Finally analyzing the correlation between the predictive signs which were obtained by chi-square test and lymph node metastasis of thyroid cancer.Results:Univariate chi-square test showed that the incidence of cervical lymph node metastasis in the age under 44 years old was 59.3%(76/128),higher than 43.0%(41/72)in the age above 44 years old,and the difference was statistically significant(x~2=4.933,P<0.05).There were significant differences in the incidence of cervical lymph node metastasis among diameter is longer than or equal to 10 mm(x~2=20.827,P<0.05),microcalcifications(x~2=20.827,P<0.05),ultrasonic attenuation(x~2=7.676,P<0.05)and blood flow grade 3(x~2=10.425,P<0.05).The gender of the patients,the number,size,boundary,aspect ratio and echo of the nodules were not statistically significant in the incidence of cervical lymph node metastasis(P>0.05).Logistic regression analysis showed that the diameter is longer than or equal to 10 mm(P<0.001,OR 2.790,95%CI 1.587-4.916),microcalcifications(P 0.009,OR 2.085,95%CI1.206-3.605),ultrasonic attenuation(P 0.018,OR 2.499,95%CI1.168-5.349)and blood flow grade 3(P 0.352,OR 1.147,95%CI0.859-1.531)were associated with cervical lymph node metastasis of papillary thyroid carcinoma(P<0.05),and there was a positive correlation between Logistic regression analysis showed that the diameter is longer than or equal to10 mm,microcalcifications and ultrasonic attenuation.The diameter is longer than or equal to 10 mm,microcalcifications and ultrasonic attenuation were independent predictors of cervical lymph node metastasis of thyroid cancer.Conclusion(s):The general ultrasonographic features of papillary thyroid carcinoma,including diameter is longer than or equal to 10 mm,microcalcifications and ultrasonic attenuation,have predictive value for cervical lymph node metastasis.In supersonic inspection,if the papillary thyroid carcinoma nodules with the ultrasonographic features above,combined with the age under 44 years old,the possibility of cervical lymph node metastasis should be considered.