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| Predictive value of CT combined with clinical features in diagnosing central lymph node metastasis of#br#
papillary thyroid carcinoma in stage cN0 |
1.Department of Radiology, Hangzhou Fuyang District People’s Hospital, Hangzhou 311400, China;
2.Department of Radiology, Xiaoshan District First People’s Hospital of Hangzhou, Hangzhou 311200, China;
3.Department of Radiology, First People’s Hospital of Hangzhou, Hangzhou Thyroid Disease Treatment Center,
Hangzhou 310006, China |
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Abstract Objective: To investigate the predictive value of CT combined with clinical features in diagnosing central lymph node metastasis of papillary thyroid carcinoma in stage cN0. Methods: The CT signs and clinical features of 390 cases of PTC confirmed by surgery and pathology were reviewed. The threshold of PTC diameter was identified by ROC. The location of tumor, thyroid edge contact, calcification, boundary on plain scan, boundary on enhanced scan, diameter, age, gender and relation with CLNM were analyzed by univariate and multivariate logistic regression method. The sensitivity and specificity of single factor and combined multiple risk factors in positive CLNM were calculated. Results: Among 390 cases of PTC in stage cN0, there were 109 cases of CLNM positive and 281 cases of CLNM negative. ROC curve showed that when the diameter=0.7 cm, the Youden index is maximum. Univariate analysis indicated that thyroid edge contact, diameter, age and gender were correlated with CLNM positive, of which, thyroid edge contact, diameter >0.7 cm, age <45 years and men were more common in CLNM(P<0.05). Multivariate logistic regression analysis further indicated that thyroid edge contact, age <45 years and men were associated with CLNM positive, while diameter was not associated with CLNM. The sensitivity and specificity of individual risk factor were 30%~85% and 34%~83% respectively. The sensitivity and specificity of combination of two or more risk factors were 12%~49% and 74%~94%, respectively. Conclusion: The individual risk factors of CLNM positive are thyroid edge contact, age <45 years, and men. The combination of multiple risk factors can significantly enhance the specificity of preoperative diagnosis, providing important basis for lymphadenectomy of PTC in stage cN0.
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Received: 15 January 2016
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2016, Vol. 27 
