Prediction of lymph node metastasis in cN0 papillary thyroid microcarcinoma by CT texture analysis combined with baseline data / 中华内分泌外科杂志

ABSTRACT

Objective:To explore and analyze the value of CT texture combined with baseline data in lymph node metastasis of cN0 papillary thyroid microcarcinoma (PTMC), in order to provide evidence for the evaluation of lymph node metastasis of PTMC.Methods:106 patients with single stage cN0 papillary PTMC confirmed by operation and pathology in Department of Radiology and Hernia Department of Huzhou First People’s Hospital from Aug. 2020 to Aug. 2022 were selected for retrospective analysis. Metastatic lymph nodes and non-metastatic lymph nodes were delineated in CT images, and they were divided into a lymph node metastasis group (22 cases) and a group without lymph node metastasis (84 cases). At the same time, lymph node CT texture feature images were obtained in both groups. Logistic regression was used to analyze the relationship between CT texture and lymph node metastasis, and ROC curve was drawn to evaluate the predictive value of CT texture for lymph node metastasis in cN0 stage PTMC patients. The patients were divided into<1/4 group (51 cases), 1/4-<1/2 group (36 cases), and ≥1/2 group (19 cases) according to the different contact range between tumor and thyroid margin in CT signs. The baseline data and lymph metastasis distribution of each group were analyzed.Results:The results of single factor analysis showed that there were no differences in tumor location, tumor calcification or thyroglobulin in CT texture between LNM group and non-LNM group ( P>0.05). The incidence of tumor contact with thyroid margin, tumor diameter ≥7 mm, age<45 and male ratio of sex in LNM group were higher than those in non-LNM group ( P<0.05). Multivariate Logistic regression analysis showed that tumor was in contact with thyroid margin ( OR=6.080, 95% CI: 1.738-21.273), tumor diameter ≥7 mm ( OR=2.779, 95% CI: 1.135-6.805), age<45 years old ( OR=6.074, 95%CI: 1.980-18.636) and gender male ( OR=12.642, 95% CI: 3.125-51.136) were independent risk factors for lymph node metastasis in cN0 stage PTMC patients ( P<0.05). There were no significant differences in gender, age, tumor diameter, tumor location, tumor calcification or thyroglobulin among<1/4 group, 1/4-1/2 group and ≥1/2 group ( P>0.05). The incidence of LNM in ≥1/2 group was higher than that in<1/4 group and 1/4-1/2 group, and pairwise comparison between groups had statistical significance ( P<0.05) . Conclusions:It is an independent risk factor for lymph node metastasis in cN0 stage PTMC patients with tumor and thyroid boundary contact, tumor diameter ≥7 mm, age<45 years old, male, and the wider the tumor and thyroid boundary contact, the higher the risk of lymph node metastasis. CT texture analysis combined with baseline data has important reference value in predicting lymph node metastasis of cN0 TMPC.