Central lymph nodes in frozen sections can effectively guide extended lymph node resection for papillary thyroid carcinoma

作者全名："Peng, Li; Zheng, Xiaoya; Xue, Ying; Huang, Chun; Su, XinLiang; Yu, Shanshan"

作者地址："[Peng, Li; Xue, Ying; Yu, Shanshan] Chongqing Med Univ, Testing Ctr, Dept Pathol & Mol Med Diagnost, Chongqing 400016, Peoples R China; [Zheng, Xiaoya] Chongqing Med Univ, Dept Endocrinol, Affiliated Hosp 1, Chongqing, Peoples R China; [Huang, Chun; Su, XinLiang] Chongqing Med Univ, Dept Thyroid & Breast Surg, Affiliated Hosp 1, Chongqing, Peoples R China"

通信作者："Yu, SS (通讯作者)，Chongqing Med Univ, Testing Ctr, Dept Pathol & Mol Med Diagnost, Chongqing 400016, Peoples R China.; Su, XL (通讯作者)，Chongqing Med Univ, Dept Thyroid & Breast Surg, Affiliated Hosp 1, Chongqing, Peoples R China."

来源：ANNALS OF MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001119025800001

JCR分区：Q1

影响因子：4.9

年份：2023

卷号：55

期号：2

开始页：　

结束页：　

文献类型：Article

关键词：Papillary thyroid carcinoma (PTC); lateral lymph node dissection (LND); lymph node metastasis (LNM); number; metastatic diameter

摘要："Objectives: The scope of lateral neck lymph node dissection (LND) in papillary thyroid carcinoma (PTC) remains controversial. Our research aimed to explore the value of central lymph node metastasis (CLNM) in frozen sections for predicting neck lateral lymph node metastasis (NLLNM) and to guide clinical surgeons in performing surgical lymph node dissection.Patients: A total of 275 patients with PTC with suspected 'Cervical lymph node metastasis (LNM, including CLNM and NLLNM)' underwent unilateral or bilateral thyroidectomy and an intraoperative frozen diagnosis of central lymph nodes (LNs), as well as central and neck lateral LND. Validity indices and consistency of central LNs in frozen sections were calculated. In total, 216 patients then met the inclusion criteria and were enrolled in the follow-up study. The clinical and pathological data of the patients were retrospectively analyzed. The relationship between the number, metastatic diameter, and the ratio of CLNM to NLLNM was investigated.Results: CLNM in frozen and paraffin-embedded sections was associated with NLLNM. Univariate and multivariate analyses revealed the following risk factors for NLLNM metastasis: maximum diameter, total number, and ratio of metastatic LNs. A significant result was obtained when a cut-off value of 2.050 mm for the maximum metastatic diameter, 5.5 in the total number, and 0.5342 for the CLNM ratio level was used. Interaction term analyses showed that the association between the number of CLNM and NLLNM differed according to maximum diameter.Conclusion: Central LNs in frozen sections accurately predicted NLLNM. In patients with PTC with >5 CLNMs, >= 2 and <= 5 CLNMs and maximum metastatic diameter > 2 mm, neck lateral LND should be considered. Our findings will facilitate the identification of patients who are likely to benefit from extended lateral neck LND."

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