Predicting the factors of lateral lymph node metastasis in papillary microcarcinoma of the thyroid in eastern China

Zeng, Rui-chao; Li, Quan; Lin, Kan; Zhang, Wei; Gao, Er-li; Huang, Guiqian; Zhang, Xiaohua; Zheng, Min

doi:10.1007/s12094-012-0875-2

Cited by 32 publications

(37 citation statements)

References 29 publications

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“…However, the univariate and multivariate analyses confirmed tumor size >5 mm as an independent predictor of LNM. A number of previous studies reported the upper pole location as an independent predictive factor for lateral LNM (23,29). To the best of our knowledge, few reports have defined the statistical correlation between tumor location and CLNM in PTMC.…”

Section: Discussionmentioning

confidence: 96%

“…TTD >10 mm were independent predictors for CLNM from the multivariate analysis. Zeng et al (23) indicated that certain US characteristics (upper pole location, no well-defined margin and presence of calcifications) were predictive factors for lateral LNM in patients with PTMC in Eastern China. Few studies have reported the associations between US characteristics and CLNM.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

et al. 2015

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Abstract. Central lymph node metastasis (CLNM) is common in papillary thyroid microcarcinoma (PTMC). The aim of the present study was to investigate the risk factors associated with CLNM in clinical lateral cervical lymph node-negative (cN0) PTMC in Eastern China. A total of 392 patients with confirmed PTMC by histological examination who underwent thyroidectomy and central neck lymph node dissection (CND) between May 2011 and October 2012 at the First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China) were enrolled. The clinicopathological and ultrasonographic data from the patients were analyzed retrospectively. A scoring system was developed on the basis of independent predictive factors for CLNM. Male gender, age <45 years, maximum tumor diameter >5 mm, lower lobe location, multifocal carcinoma with total tumor diameter >10 mm and extracapsular spread were independent predictive factors for CLNM according to logistic regression analysis. The clinicopathological score was statistically significant, with an index point ≥2 indicating CLNM with 86.2% sensitivity and 70.4% specificity. The findings of the present study indicate that CND may be recommended to be routinely performed when the clinicopathological index point ≥2.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

et al. 2015

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“…Several studies reported that the presence of clinical lymph node metastasis in PTMC was one of the most important prognostic indicators, whereas others demonstrated that pathological lymph node metastasis identified following prophylactic dissection did not significantly affect patient prognosis. Pathological lymph node metastasis from PTMC was found in a range of 26-56% (15)(16)(17)(18)(19)(20). The reason(s) for the difference between clinical and pathological lymph node metastasis have not been fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

E-cadherin expression and cell proliferation in the primary tumor and metastatic lymph nodes of papillary thyroid microcarcinoma

Nakamura

Onoda

Noda

et al. 2013

Molecular and Clinical Oncology

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Abstract. Although papillary thyroid microcarcinoma (PTMC) has an excellent prognosis, certain cases exhibit aggressive clinical manifestations. In this study, we assessed the expression of E-cadherin and Ki-67 in primary PTMC tumors and metastatic lymph nodes, in order to investigate the mechanism underlying the mainly indolent but potentially malignant nature of PTMC. A total of 93 PTMC patients treated in our institute were included in this study. All primary tumors and 57 metastatic lymph nodes were immunohistochemically stained and a total of 73 tumors (78.5%) were positive for E-cadherin. E-cadherin expression was significantly less common at the invasive front (58.1%, P<0.01) compared to that at the center of the tumor. Tumors that had lost E-cadherin expression at the invasive front frequently presented with lymph node metastasis (70.6%). Small tumors (≤5 mm diameter) expressed E-cadherin significantly more frequently compared with larger tumors (P=0.04); however, no other particular characteristic was found to correlate with the status of E-cadherin expression in the primary tumors. E-cadherin expression was detected in 49 (86.0%) of the 57 metastatic foci and correlated significantly with the expression status at the invasive front of the tumor (P=0.02). The Ki-67 index was universally low and was not correlated with the clinicopathological characteristics or the E-cadherin expression of the tumors. These results suggested that cancer cells in the metastatic lymph nodes exhibit indolent characteristics, similar to those of the primary PTMC. However, the metastatic cancer cells may have already completed the process of epithelial-to-mesenchymal transition (EMT) and mesenchymal-to-epithelial transition (MET), suggesting an innate malignant potential. IntroductionAccording to the World Health Organization classification system for thyroid tumors, papillary thyroid microcarcinoma (PTMC) is defined as a papillary thyroid carcinoma (PTC) measuring ≤10 mm in its greatest dimension (1). The occurrence of PTMC is on the increase worldwide (2-4), along with the frequent application of neck ultrasonography (US) (5,6). PTMC is generally characterized by an indolent clinical course and has an excellent prognosis, with a disease-specific mortality of <0.5% (6). However, certain PTMC cases were found to be clinically aggressive (6,7). According to the observations of Sugitani et al (7), PTMC patients with bulky lymph node metastases or extrathyroidal invasion were at the highest risk for a cancer-specific fatal outcome. Those observations suggested that there is a group of PTMCs that have already acquired highly malignant potential. However, the basic mechanism underlying the development of aggressive characteristics in these tumors has not yet been identified.The reported risk factors for PTMC recurrence were shown to be male gender (8,9), extent of primary surgery (10), presence of lymph node metastases at initial diagnosis (3,(8)(9)(10)(11)(12), tumor multifocality (3,8,12) and capsular invasion (9,(11)(12)(13)(14...

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“…По данным литерату-ры, метастатическое поражение лимфоузлов было выявлено в 25-30% случаев [34,[43][44][45][46][47][48].…”

Section: микрокарциномы с метастатическим поражением лимфоузловunclassified

“…Несколько исследователей сообщили, что наличие метастазов в лимфатические узлы при микрокар-циномах является одним из наиболее важных про-гностических факторов, тогда как другие считают, что поражение лимфатических узлов существенно не влияет на прогноз пациента. Метастатическое пора-жение лимфоузлов при микрокарциномах было вы-явлено в 26-56% случаев [43][44][45][46][47][48].…”

Section: агрессивное лечение микрокарцином или их агрессивное течение?unclassified

Papillary thyroid microcarcinoma

et al. 2015

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Predicting the factors of lateral lymph node metastasis in papillary microcarcinoma of the thyroid in eastern China

Cited by 32 publications

References 29 publications

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

E-cadherin expression and cell proliferation in the primary tumor and metastatic lymph nodes of papillary thyroid microcarcinoma

Papillary thyroid microcarcinoma

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