Title: Clinical analysis of medullary thyroid carcinoma and risk factors of cervical lymph node metastasis
Abstract: Objective
To analyze the clinical features of medullary thyroid carcinoma (MTC) and the risk factors of cervical lymph node metastasis.
Methods
A retrospective analysis of 84 cases of thyroid surgery in the First Affiliated Hospital of Zhengzhou University from Jan. 2012 to Jun. 2018 and confirmed by routine pathology as MTC patients was performed. Chi-square test and logistic regression were used to analyze patients’ age, gender, clinical features such as tumor diameter, number of lesions, and invasion of the capsule and risk factors associated with cervical lymph node metastasis.
Results
Statistical analysis found that the incidence of lymph node metastasis significantly increased in patients with central region ≥1 cm (χ2=4.196, P=0.041) , multiple lesions (χ2=5.946, P=0.015) , and thyroid capsule invasion (χ2=15.277, P 200 pg/ml, and the cervical lymph node metastasis rate was 55.4% (31/56) . 28 patients had preoperative calcitonin 30 ng/ml, cervical lymph node metastasis was 75% (6/8) ; 10 patients had CEA<30 ng/ml, and the cervical lymph node metastasis was 60% (6/10) .
Conclusions
Higher cervical lymph node metastasis is a clinical feature of MTC. For patients with thyroid capsule invasion, the risk of cervical lymph node metastasis is significantly increased, and prophylactic cervical lymph node dissection is required. Preoperative detection of calcitonin and CEA can be used to diagnose MTC and predict lymph node metastasis. The cervical lymph node dissection can be considered with reference to the concentration.
Key words:
Medullary thyroid carcinoma; Lymph node metastasis; Calcitonin; Carcinoembryonic antigen
Publication Year: 2019
Publication Date: 2019-04-25
Language: en
Type: article
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