The Predictive Value of Conventional Ultrasound Signs Plus Serological Indices for Neck Lymph Node Metastasis in Papillary Thyroid Cancer

Abstract

The present study aimed to evaluate the predictive value of conventional ultrasound signs and serological indices in the detection of neck lymph node metastasis in papillary thyroid cancer (PTC). A total of 80 patients with PTC scheduled for surgery in our hospital between August 2019 and December 2022 were recruited. Patients with neck lymph node metastasis were categorized as the experimental group, and patients without neck lymph node metastasis were included in the control group. Patients’ ultrasound signs were analyzed, and serological indices were determined. Logistic analysis was performed to determine the risk factors for the development of postoperative neck lymph node metastasis in papillary thyroid cancer, and the receiver operating characteristic (ROC) curve was employed to assess their diagnostic efficiency. Significant differences were observed in the number of lesions, nodule size, calcification, blood flow RI, and PI values comparison between the two arms (P < 0.05), while no significant differences were found in other ultrasound signs (P > 0.05). Patients with neck lymph node metastasis exhibited significantly higher serum concentrations of thyroid stimulating hormone (TSH) and anti-thyroglobulin antibodies (TG-Ab) versus those without metastasis (P < 0.05). Nodule size, number of lesions, and serum TSH level were independent risk factors for metastasis in neck lymph nodes in patients with papillary thyroid cancer (P <0.05). Conventional ultrasound signs, combined with serologic indices, demonstrated the highest diagnostic efficiency for predicting neck lymph node metastasis in patients with papillary thyroid cancer. These findings showed a sensitivity of 0.868, specificity of 0.894, and an area under the ROC curve (AUC) of 0.918. Additionally, the Jorden index was calculated to be 0.761. Analysis revealed that nodule size, number of lesions, and serum TSH concentration were independent risk factors for neck lymph node metastasis in papillary thyroid cancer patients. The combination of conventional ultrasound signs and serologic indices provided a higher diagnostic value compared to using a single diagnostic modality, thus indicating promising clinical benefits.