Skip to main content

Advertisement

SpringerLink
Log in

Prediction of thyroid extracapsular extension with cervical lymph node metastases (ECE-LN) by CEUS and BRAF expression in papillary thyroid carcinoma

  • Research Article
  • Published:
Tumor Biology

Abstract

The aim of our study was to find a specific imaging (contrast-enhanced ultrasound, CEUS) to detect extracapsular extension and cervical lymph node metastases (ECE-LNM) that associated with BRAF protein expression in papillary thyroid carcinoma (PTC). Preoperative utrasonography (US) or CEUS was performed in the diagnosis of extracapsular extension (ECE) in 317 patients with 369 PTC. BRAF protein status was tested on the primary tumor and lymph node involvement. The diagnostic accuracy of CEUS and US was evaluated after thyroid surgery. The association between CEUS and BRAF expression were then analyzed to investigate the diagnostic value of ECE-LNM in PTC. The sensitivity and specificity of CEUS were higher than those in US in the diagnosis of ECE in patients with PTC (91.1, 86.5 vs 49, 55 %). BRAF protein overexpression were significantly associated with ECE (P = 0.0003) and lymph node metastasis (LNM) positive cases (P = 0.0014). The results of CEUS, not US, have a significant correlation with BRAF expression status in PTC samples (P < 0.0001). Associated with BRAF protein expression status, the routine preoperative CEUS could have a good value in the diagnosis of ECE-LNM in PTC and facilitate a surgeon to improve further clinical management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA. 2006;295:2164–7.

    Article  CAS  PubMed  Google Scholar 

  2. Qian B, Chen K, He M, Dong SF, Han HW, Lei L, et al. The survey on thyroid carcinoma incidence in urban district of Tianjin. Chin J Clin Oncol. 2005;32:218–21. Article in Chinese.

    Google Scholar 

  3. Mirallie E, Visset J, Sagan C, Hamy A, Le Bodic MF, Paineau J. Localization of cervical node metastasis of papillary thyroid carcinoma. World J Surg. 1999;23:970–3.

    Article  CAS  PubMed  Google Scholar 

  4. Wada N, Duh QY, Sugino K, Iwasaki H, Kameyama K, Mimura T, et al. Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optical strategy for neck dissection. Ann Surg. 2003;237:399–407.

    PubMed Central  PubMed  Google Scholar 

  5. Pereira JA, Jimeno J, Miquel J, Iglesias M. Munne’ A, Sancho JJ, Sitges-Serra A. Nodal yield, morbidity, and recurrence after central neck dissection for papillary thyroid carcinoma. Surgery. 2005;138:1095–100.

    Article  PubMed  Google Scholar 

  6. Mazzaferri EL, Kloos RT. Clinical review 128: current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab. 2001;86:1447–63.

    Article  CAS  PubMed  Google Scholar 

  7. Hay ID, Bergstralh EJ, Grant CS, McIver B, Thompson GB, van Heerden JA, et al. Impact of primary surgery on outcome in 300 patients with pathologic tumor-node-metastasis stage III papillary thyroid carcinoma treated at one institution from 1940 through 1989. Surgery. 1999;126:1173–81.

    Article  CAS  PubMed  Google Scholar 

  8. Tsang RW, Brierley JD, Simpson WJ, Panzarella T, Gospodarowicz MK, Sut-cliffe SB. The effects of surgery, radioiodine, and external radiation therapy on the clinical outcome of patients with differentiated thyroid carcinoma. Cancer. 1998;82:375–88.

    Article  CAS  PubMed  Google Scholar 

  9. Kouvaraki MA, Shapiro SE, Fornage BD, Edeiken-Monro BS, Sherman SI, Vassilopoulou-Sellin R, et al. Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. Surgery. 2003;134:946–54.

    Article  PubMed  Google Scholar 

  10. Ishigaki S, Shimamoto K, Satake H, Sawaki A, Itoh S, Ikeda M, et al. Multi-slice CT of thyroid nodules: comparison with ultrasonography. Radiat Med. 2004;22:346–53.

    PubMed  Google Scholar 

  11. King AD, Ahuja AT, To EW, Tse GM, Metreweli C. Staging papillary carcinoma of the thyroid: magnetic resonance imaging vs ultrasound of the neck. Clin Radiol. 2000;55:222–6.

    Article  CAS  PubMed  Google Scholar 

  12. Shimamoto K, Satake H, Sawaki A, Ishigaki T, Funahashi H, Imai T. Preoperative staging of thyroid papillary carcinoma with ultrasonography. Eur J Radiol. 1998;29:4–10.

    Article  CAS  PubMed  Google Scholar 

  13. Dănilă M, Sporea I, Sirli R, Popescu A, Sendroiu M, Martie A. The role of contrast enhanced ultrasound (CEUS) in the assessment of liver nodules in patients with cirrhosis. Med Ultrason. 2010;12:145–9.

    PubMed  Google Scholar 

  14. Agha A, Jung EM, Janke M, Hornung M, Georgieva M, Schlitt HJ, et al. Preoperative diagnosis of thyroid adenomas using high resolution contrast-enhanced ultrasound (CEUS). Clin Hemorheol Microcirc. 2013;55:403–9.

    CAS  PubMed  Google Scholar 

  15. Ma JJ, Ding H, Xu BH, Xu C, Song LJ, Huang BJ, et al. Diagnostic performances of various gray-scale, color Doppler, and contrast-enhanced ultrasonography findings in predicting malignant thyroid nodules. Thyroid. 2014;24:355–63.

    Article  PubMed  Google Scholar 

  16. Rossi ED, Martini M, Capodimonti S, Lombardi CP, Pontecorvi A, Vellone VG, et al. BRAF (V600E) mutation analysis on liquid-based cytology-processed aspiration biopsies predicts bilaterality and lymph node involvement in papillary thyroid microcarcinoma. Cancer Cytopathol. 2013;121:291–7.

    Article  CAS  PubMed  Google Scholar 

  17. Namba H, Nakashima M, Hayashi T, Hayashida N, Maeda S, Rogounovitch TI, et al. Clinical implication of hot spot BRAF mutation, V599E, in papillary thyroid cancers. J Clin Endocrinol Metab. 2003;88:4393–7.

    Article  CAS  PubMed  Google Scholar 

  18. Xing M, Westra WH, Tufano RP, Cohen Y, Rosenbaum E, Rhoden KJ, et al. BRAF mutation predicts a poorer clinical prognosis for papillary thyroid cancer. J Clin Endocrinol Metab. 2005;90:6373–9.

    Article  CAS  PubMed  Google Scholar 

  19. Kabaker AS, Tublin ME, Nikiforov YE, Armstrong MJ, Hodak SP, Stang MT, et al. Suspicious ultrasound characteristics predict BRAF V600E-positive papillary thyroid carcinoma. Thyroid. 2012;22:585–9.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Patron V, Hitier M, Bedfert C, Métreau A, Dugué A, Jegoux F. Predictive factors for lateral occult lymph node metastasis in papillary thyroid carcinoma. Eur Arch Otorhinolaryngol. 2013;270:2095–100.

    Article  PubMed  Google Scholar 

  21. Kim KE, Kim EK, Yoon JH, Han KH, Moon HJ, Kwak JY. Preoperative prediction of central lymph node metastasis in thyroid papillary microcarcinoma using clinicopathologic and sonographic features. World J Surg. 2013;37:385–91.

    Article  PubMed  Google Scholar 

  22. Joo JY, Park JY, Yoon YH, Choi B, Kim JM, Jo YS, et al. Prediction of occult central lymph node metastasis in papillary thyroid carcinoma by preoperative braf analysis using fine-needle aspiration biopsy: a prospective study. J Clin Endocrinol Metab. 2012;97:3996–4003.

    Article  CAS  PubMed  Google Scholar 

  23. Lee YS, Lim YS, Lee JC, Wang SG, Kim IJ, Son SM, et al. Nodal status of central lymph nodes as a negative prognostic factor forpapillary thyroid carcinoma. J Surg Oncol. 2013;107:777–82.

    Article  PubMed  Google Scholar 

  24. Leboulleux S, Rubino C, Baudin E, Caillou B, Hartl DM, Bidart JM, et al. Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metab. 2005;90:5723–9.

    Article  CAS  PubMed  Google Scholar 

  25. Ito Y, Hirokawa M, Uruno T, Kihara M, Higashiyama T, Takamura Y, et al. Biological behavior and prognosis of encapsulated papillary carcinoma of the thyroid: experience of a Japanese hospital for thyroid care. World J Surg. 2008;32:1789–94.

    Article  PubMed  Google Scholar 

  26. Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87:1941–6.

    Article  CAS  PubMed  Google Scholar 

  27. Feng L, Li M, Zhang QP, Piao ZA, Wang ZH, Lv S. Utility of BRAF protein overexpression in predicting the metastasis potential of papillary thyroid carcinoma. Oncol Lett. 2011;2:59–63.

    PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

None

Author information

Authors and Affiliations

  1. Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China

    Xi Wei & Sheng Zhang

  2. The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China

    Ying Li

  3. Department of Thyroid and Cervical Tumor, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Huanhuxi Road, Hexi District, 300060, Tianjin, China

    Ming Gao

Authors
  1. Xi Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ying Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sheng Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ming Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ming Gao.

Additional information

Xi Wei, Ying Li, and Sheng Zhang contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wei, X., Li, Y., Zhang, S. et al. Prediction of thyroid extracapsular extension with cervical lymph node metastases (ECE-LN) by CEUS and BRAF expression in papillary thyroid carcinoma. Tumor Biol. 35, 8559–8564 (2014). https://doi.org/10.1007/s13277-014-2119-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13277-014-2119-2

Keywords

Search

Navigation