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Prediction of bilateral thyroid carcinoma and lateral cervical lymph node metastasis in PTC patients with suspicious
Shuai Dong1, Jun Pan2, Xiao-Long Du2
1Department of Thyroid Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China. donshai@zju.edu.cn.
Endocrine
|March 19, 2024
Summary
Multifocality and contralateral nodules in the upper and middle thyroid are key predictors of bilateral papillary thyroid carcinoma (PTC). Bilateral PTC, male sex, upper tumor location, and punctate echogenic foci predict lateral cervical lymph node metastasis.
Area of Science:
- Endocrinology
- Oncology
- Surgical Pathology
Background:
- Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy.
- Understanding factors predicting bilateral disease and lymph node metastasis is crucial for effective treatment planning.
Purpose of the Study:
- To identify clinical and histopathological factors associated with bilateral PTC.
- To determine predictors of lateral cervical lymph node metastasis (LLNM) in patients with unilateral PTC.
Main Methods:
- Retrospective analysis of 256 patients with suspicious unilateral PTC.
- Logistic regression analysis to evaluate demographic, anthropometric, lifestyle, medical history, diagnostic, and histopathological factors.
- Assessment of factors for bilateral PTC and LLNM.
Main Results:
- Multifocality (aOR: 5.069) and contralateral nodules in the upper (aOR: 9.073) and middle (aOR: 9.926) thyroid lobes were associated with bilateral PTC.
- LLNM was associated with bilateral PTC (aOR: 4.283), male sex (aOR: 3.377), upper tumor location (aOR: 3.311), and punctate echogenic foci (aOR: 3.309).
- Contralateral nodules in all thyroid lobes were inversely associated with LLNM.
Conclusions:
- Tumor multifocality and contralateral nodule location (upper and middle) predict bilateral PTC.
- Bilateral PTC, male sex, upper tumor location, punctate echogenic foci, and contralateral nodule presence are independent predictors of LLNM.
