ABSTRACT
Objective:
To investigate the relationship between preoperative
serum thyroglobulin (Tg) and clinical data with the
risk of cervical
lymph node metastasis in
patients with
papillary thyroid carcinoma (PTC) .
Methods:
Data of 395 PTC
patients who underwent
surgery from Feb. 2016 to Jun. 2019 at the Second Affiliated
Hospital of Soochow
University were retrospectively analyzed. Based on whether cervical
lymph nodes had
metastasis,
patients were classified into central
lymph node metastasis positive group ( n=195 cases) , central
lymph node metastasis negative group ( n=200 cases) , lateral
lymph node metastasis positive group ( n=72 cases) , and lateral
lymph node metastasis negative group ( n=323 cases) .Then the relationship between age,
sex, multifocality,
tumor diameter, capsular invasion, preoperative TSH and preoperative Tg with
lymph node metastasis were analyzed by SPSS. Comparisons between groups were performed by χ2 test and rank sum test. Prediction
efficiency of the preoperative Tg and
Logistic regression model was estimated by
receiver operating characteristic (ROC) curve. A total of 100 PTC
patients confirmed by pathological results in the Second Affiliated
Hospital of Soochow
University from Jul. 2019 to Apr. 2020 were selected as the validation data.
Results:
Multi-factor
Logistic regression showed that age,
tumor diameter, capsular invasion and preoperative Tg were independent
risk factors of central cervical
lymphatic metastasis ( P<0.05) ;
Tumor diameter, capsular invasion, central cervical
lymphatic metastasis and preoperative Tg were independent
risk factors of lateral cervical
lymphatic metastasis ( P<0.05) . The area under the
ROC curve (
AUC) for diagnosing central
lymph node metastasis by preoperative Tg was 0.710, with a
sensitivity of 49.2%, and
specificity of 88.5%. The
AUC for diagnosing lateral
lymph node metastasis by preoperative Tg was 0.728, with a
sensitivity of 59.7%, and
specificity of 89.5%. The
AUC for diagnosing central
lymph node metastasis by the prediction model was 0.773, with a
sensitivity of 78.5%, and
specificity of 64.5%.The
AUC for diagnosing lateral
lymph node metastasis by the prediction model was 0.869, with a
sensitivity of 84.7%, and
specificity of 70.3%.
Conclusions:
The preoperative
serum Tg level is correlated with cervical
lymph node metastasis in PTC
patients. But the
Logistic regression model based on preoperative Tg and other independent
risk factors shows a better predictive value.