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Risk of cervical lymph node metastasis in papillary thyroid carcinoma: Correlations with lymphangiogenesis and ultrasound features
- Alternative Title
- 최윤정
- Author(s)
- Choi, Yoon-Jung
- Alternative Author(s)
- 최윤정
- Advisor
- 박경주
- Department
- 일반대학원 의학과
- Publisher
- The Graduate School, Ajou University
- Publication Year
- 2013-02
- Language
- eng
- Alternative Abstract
- Stratification of risk factors for cervical lymph node metastasis (LNM) in thyroid papillary carcinoma is important for providing standards for post-operative adjuvant radio-iodine therapy and for predicting patient prognosis. We investigated pathological factors based on the lymphatic vessel system and ultrasound features associated with tumor with cervical LNM. Among patients who had undergone thyroidectomy confirmed to be papillary thyroid carcinoma, we selected 126 age-sex matched paired patients without cervical LNM (group 1) and with LNM (group 2) to evaluate risk factors. Pathological factors evaluated were size, multiplicity, and extra thyroid extension state, based on the pathological reports using stored data. The lymphatic vessel density (LVD) of each tumor was evaluated by staining for VEGFR-3 and D2-40 and correlated with cervical LNM state. Ultrasound features were evaluated to compare the differences between these two groups. Larger tumor size, multiplicity, extrathyroid extension were more common in group 2 (p<0.05). The median percentage of VEGFR-3 for group 1 was 20 (range 0-30) and D2-40 was 13 (range 7-23) while for group 2, VEGFR-3 was 80 (70-90) and D2-40 was 78 (54-114). LVD measured by intratumoral D2-40 staining was 20.6% and 79.4% for group 1 and group 2, respectively. Intra-tumoral lymphatics measured by D2-40 stain had a strong correlation with cervical LNM (Odds 1.230, CI 1.01.-1.499 p value 0.040). US features had no significant differences between the two groups although calcifications tended to be higher in group 2 (84% vs 76% p=0.264). Lymphatic vessel density and nodule echogenicity did not show correlations. Intratumoral lymphangiogenesis was most strongly associated with LNM and thus, could be a useful predictive marker for cervical LNM.
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- Appears in Collections:
- Graduate School of Ajou University > Department of Medicine > 3. Theses(Master)
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