Predicting cervical lymph node metastasis in papillary thyroid carcinoma using capsule disruption length measured by...

Area of Science:

• Endocrinology
• Oncology
• Radiology

Background:

• Papillary thyroid carcinoma (PTC) frequently metastasizes to lymph nodes.
• Accurate preoperative prediction of lymph node metastasis (LNM) is crucial for effective surgical management.
• Current ultrasound criteria for extrathyroidal extension (ETE) and LNM prediction are debated.

Purpose of the Study:

• To evaluate the efficacy of length of capsule disruption (LCD) measured by 3D ultrasound in predicting cervical LNM in PTC patients.
• To develop a predictive model for LNM risk in PTC.

Main Methods:

• A prospective cohort study involving 126 PTC patients examined using 3D ultrasound (3D-US).
• Measurement of LCD using the omniview mode of 3D-US.
• Statistical analysis including logistic regression and ROC curve analysis to assess LNM prediction and construct a nomogram.

Main Results:

• LCD ≥ 0.42 cm was significantly associated with increased LNM risk (odds ratio 4.097).
• Factors including younger age, male gender, larger nodule size, LCD, echogenic foci, and thyroid capsule invasion correlated with LNM.
• A nomogram incorporating gender, age, maximum nodule diameter, and LCD demonstrated good predictive performance (AUC = 0.795).

Conclusions:

• LCD measured by 3D-US is a valuable predictor of cervical LNM in PTC.
• The developed nomogram provides a practical tool for preoperative LNM risk assessment.
• This approach can guide surgical decisions, optimizing treatment and patient outcomes.