Abstract:

Objective

To explore the differences between ultrasound imaging and pathological measurements of papillary thyroid carcinoma (PTC), and to discuss the related influencing factors.

Methods

Patients who underwent partial or total thyroidectomy in the Department of Thyroid Surgery of Shangyu People’s Hospital of Shaoxing from January 2023 to December 2023 were selected, and their pathology confirmed that they had single-occurrence papillary thyroid carcinoma (PTC) in a single thyroid lobe.The sizes of cancer lesions on ultrasonic images, on gross specimens, and under the microscope were collected.The Kruskal-Wallis H test was used to compare the differences in the sizes of the cancerous lesions measured by the three measurement methods.Logistic multivariate regression analysis was performed on the influencing factors of the differences between the pathological measurement results under the microscope and the ultrasonic measurement results.The chi-square test was used to compare the selected influencing factors,respectively.

Results

There was no significant difference among the three measurement methods as a whole of the sizes of the cancerous lesions (P＞0.05), but there were still 21 cases (30.0%, 21/69) that showed larger values under microscopy.The differences between microscopic lesion measurements and ultrasound imaging ranged as follows: transverse diameter 0.2-2.2 mm and longitudinal diameter 0.1-0.9 mm.Logistic multiple regression analysis showed that calcification within the lesion and hyperechoic halos around the lesion were protective factors for a larger pathological range on microscopic examination (β=-2.662, P=0.039;β=-2.883, P=0.015).The chi-square test revealed that lesions with high pathological values had a higher probability of internal calcification and peripheral hyperechoic halos (15/21 vs 19/48, χ²=5.927, P=0.015;11/18 vs 8/51, χ²=9.581, P=0.001).

Conclusion

The pathological extent exceeded ultrasonographic measurements in some PTC cases, suggesting that there are small cancerous lesions around the main tumor body that cannot be displayed by ultrasound imaging.If ultrasound imaging shows microcalcifications or hyperechoic halos, the ultrasound measurement may be smaller than the pathological measurement.

Key words: Papillary thyroid carcinoma, Ultrasound, Safety boundary, Halo, Pathology