Can increased tumoral vascularity on quantitative method be a predicting factor of lymph node metastasis in papillary thyroid microcarcinoma?

Abstract

Background: To evaluate the clinical implications of the vascular index (VI) as a predicting factor for central and lateral lymph node metastasis (LNM) in patients with papillary thyroid microcarcinoma (PTMC).Methods: From January 2011 to October 2011, 588 patients (mean age, 45.2 years; 495 females, 93 males) who were diagnosed with PTMC were included. Clinicopathologic characteristics of patients and US features of the lesions including VI were evaluated retrospectively. The VI was measured using QLAB 7.0 quantification software using preoperative Doppler US images. Univariate and multivariate analysis were used to assess predictive factors of LNM.Results: From 588 patients, 140 patients (23.8%) had central LNM and 26 patients (4.4%) had lateral LNM on pathologic results. Presence of lateral LNM [odd ratio (OR) 5.464; 95% confidence interval (CI) 2.189-13.642], bilaterality (OR 2.163; 95% CI 1.165-4.014) and increased tumor size (OR 1.151; 95% CI 1.036-1.279) were significant independent factors for predicting central LNM. Presence of central LNM (OR 5.577; 95% CI 2.215-14.043), upper third location of malignancy (OR 2.499; 95% CI 1.006-6.205), and tumor size (OR 1.336; 95% CI 1.031-1.731) were significant independent factors for predicting lateral LNM. However, the VI was not a significant predicting factor for both central and lateral LNM.Conclusion: The VI of PTMC was not significantly associated with both central and lateral LNM. Central LNM was significantly associated with presence of lateral LNM, bilaterality, and increased tumor size. Lateral LNM was significantly associated with presence of central LNM, upper third location of PTMC and increased tumor size.