Multivariate analysis for the ultrasonographic characteristics of thyroid carcinoma and their correlation with cervical lymph nody metastasis

doi:10.3969/j.issn.1002-7386.2016.14.007

Abstract：Objective To investigate the ultrasonographic characteristics of thyroid carcinoma ( TC) , and to explore the correlation between the ultrasonographic characteristics and cervical lymph node metastasis ( LNM ) .Methods The preoperative ultrasonic manifestations about 196 patients with TC ( 246 thyroid carcinoma nodus ) who were diagnosed by pathology from 2006 to 2015 were retrospectively analyzed ,and the correlation between these characteristics and cervical LNM was evauated by multivariate analyses ,moreover , the ROC curve was drawn to evaluate the diagnostic significance by means of ultrasonographic characteristics of thyroid carcinoma nodus to predict cervical LNM .Results The sensitivity, specificity, positive predictive value, negative predictive value of preoperative ultrasonographic diagnosis was 81.40% (105/129), 92.32%(108/117), 92.11% (105/114),81.82% (108/132), respectively.The cervical LNM in TC was frequently occurred in cervical level VI (37.98%),next level Ⅳand level Ⅲ.Multivariate analysis showed that nodular size , contact area of capsular invasion , microcalcification and blood flow grade were risk factors for cervical LNM in patients with TC ( P <0.05).Furthermore,ROC curve analysis demonstrated important significance of nodular size ,capsular invasion,microcalcification and blood flow grade in predicting cervical LNM ,with the area under ROC curve being 0.807, 0.856, 0.881, 0.812, respectively .Conclusion The maximum diameter of thyroid carcinoma nodus , fibrous capsule invasion of thyroid gland , microcalcification and blood flow grade may be important indexes in predicting cervical LNM in patients with TC , moreover, the comprehensive evaluation of multi indexes can enhance detection rate of cervical LNM in TC and can provide valuable reference for clinical therapy .