J Korean Med Sci.  2011 Aug;26(8):996-1000. 10.3346/jkms.2011.26.8.996.

A Scoring System for Prediction of Lateral Neck Node Metastasis from Papillary Thyroid Cancer

• Jeong JJ
• Lee YS
• Lee SC
• Kang SW
• Chung WY
• Chang HS
• Seo WY
• Song KJ
• Park CS

• KMID: 1777836
• DOI: http://doi.org/10.3346/jkms.2011.26.8.996

Abstract

Lateral neck node metastasis is an important prognostic factor in thyroid carcinoma. We developed a scoring system for use in prediction of lateral neck node metastasis from papillary thyroid cancer. In this study, 161 consecutive patients were included in the training data set. This scoring system, named the Yonsei Estimated Value (YEV) for lymph node metastasis in papillary thyroid cancer, was developed on the basis of results from multivariate logistic regression analysis of preoperative clinical and radiologic data. Sixty eight consecutive patients were included for testing of the validity of the scoring system. The equation for prediction of lateral neck node metastasis was follows: YEV (Yonsei Estimated Value) = 1/(1+X) X = Exp (5.333-[0.902 x sex]+[0.036 x age]-[1.020 x tumor size]-[0.177 x lymph node size]-[0.032 x lymph node density]) When the YEV was 0.3 or more, the probability of lateral neck node metastasis was 79.0%, with sensitivity of 76.3%, specificity of 69.8%, positive predictive value of 56.7%, and negative predictive value of 85.1% in the training set. When fine needle aspiration biopsy for suspicious lateral neck nodes is not possible, or the results are inadequate, our scoring system for prediction of lateral neck node metastasis can be helpful in optimization of the surgical extent for each patient.

Keyword

Scoring System for Lateral Neck Node Metastasis; Predictive Factors; Papillary Thyroid Carcinoma

MeSH Terms

Adolescent
Adult
Aged
Algorithms
Female
Head and Neck Neoplasms/*diagnosis/secondary
Humans
Logistic Models
Lymphatic Metastasis/*diagnosis
Male
Middle Aged
*Predictive Value of Tests
Thyroid Neoplasms/*pathology/radiography
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Schematic figure of the X axis and Y axis. The lymph node is targeted according to the location in the axial plane of CT, with the Y axis defined as the distance from the sternum to the target lymph node, and the X axis is as the distance from the upper Y-axis point to the target lymph node.

• 

  Fig. 2 CT findings for lateral neck lymph nodes are CT density after contrast injection (Hounsfield Unit, HU) of the lateral neck lymph node. (A) proven nonmetastatic node, with 108 HU. (B) proven metastatic node, with 164 HU.

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  Fig. 3 Scoring system. CT, computed tomography; US, ultrasound; HU, Hounsfield units.

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