Influencing Factors and Prediction Model of False-negative Central Lymph Nodes in Thyroid Cancer Patients

The problem of false-negative lymph nodes in the central region (CLN) refers to the inability to detect lymph nodes (LN) metastasis during preoperative ultrasound examination but is confirmed by surgical and postoperative pathological examination. According to this study, the false-negative rate of CLN of patients with TC was relatively high at approximately 71.7%. The high proportion of false-negatives indicates limitations in the sensitivity of ultrasound examination, especially for detecting small LN or small metastases. The presence of false-negative CLN directly affects clinical practice. First, it may lead to insufficient selection of treatment strategies for patients with TC, thereby affecting their prognosis. Second, such false-negative results may lead surgeons to overly trust ultrasound examination during preoperative evaluation, neglecting the importance of comprehensive clinical information, and thus affecting the formulation of treatment plans. This study aimed to explore the factors influencing false-negative CLN through a cohort study and to establish a predictive model.

Sex

All

Inclusion Criteria:

1. All cases are new cases of thyroid cancer.
2. All clinical data and research materials of the cases are complete.
3. All cases underwent preoperative thyroid and neck lymph node examinations by the Ultrasound Department of Shandong Provincial Hospital.
4. All cases showed no swelling in the central lymph node status on preoperative ultrasound.
5. All cases underwent initial surgical treatment.
6. All cases were diagnosed with thyroid cancer through postoperative pathological examination.

Exclusion Criteria:

1. Except for cases of recurrence.
2. Cases with incomplete clinical data and research materials are excluded.
3. Cases that have not undergone thyroid and neck lymph node examination by the ultrasound department of Shandong Provincial Hospital before surgery are excluded.
4. Cases with enlarged lymph nodes in the central thyroid region indicated by preoperative ultrasound are excluded.
5. Excluding cases of secondary surgery.
6. Cases with postoperative pathological diagnosis of benign thyroid tumors are excluded.