Analysis Of Lymph Nodes Metastatic Features In Papillary Thyroid Carcinoma

[Objective] Papillary thyroid carcinoma can easily be transferred to the neck lymphnodes. At present, the research on the cervical lymph node metastases in thyroid cancer isRare.And the relationship between the clinicopathological features and Lymph nodemetastasis is less.Especially whether there are indicators which suggest a lymph nodemetastasis in those patients with clinically negative lymph nodes metastasis. This is also oneof the purposes of our study. At present, The scope of research of primary tumor for papillarythyroid carcinoma has reached consensus at home and abroad. However, lymphnode dissection for cervical lymph node negative patients, has not yet reached a consensus. Inthis study, the central region and lateral neck lymph nodes metastasis and clinicopathologicfeatures were analyzed, and the correlation between were also analyzed, in order to betterunderstand the characteristics of cervical lymph node metastasis, and provide an objectivereasonable choice basis of surgical treatment cervical lymph node for the Clinical surgery.[Methods] All patients from January2008to July2010in our hospital were collected,329cases of resection of thyroid cancer and central region lymph node dissection treatment ofPTC were analyzed (Including115cases of lateral cervical lymph nodes dissection at thesame time). We then analyzed the Correlation between the central region lymph node andlateral cervical lymph node metastasis and clinicopathological features. Further We thenanalyzed the Correlation between the central region lymph node and lateral cervical lymphnode metastasis and clinicopathological features in Clinical cervical lymph node-negativePatients.[Result] The329cases of patients aged14to76, the average age was43; male66cases,female263cases; The largest tumor was5.5cm, minimum0.1cm, average1.11cm; thenumber of tumors1-7, average1.76;97cases of bilateral,232cases of unilateral;145casesof central region lymph node metastasis in329, the metastasis rate44.07%,66cases of lateralcervical lymph node metastasis in115, the metastasis rate57.39%;92cases of central regionlymph node metastasis in262cases of Clinical central lymph node-negative Patients, themetastasis rate35.11%,17cases of lateral lymph node metastasis in59cases ofClinical lateral cervical lymph node-negative Patients, the metastasis rate28.81%.1.Papillary thyroid carcinoma those who were in the groups of male,＜45years old，associatedwith extrathyroidal invasion， the diameter>1cm, not associated with nodular goiter had ahigher rate of central region lymph node metastasis. And the group thatUltrasonography showed lymph node metastasis had a higher rate of central region lymphnode metastasis than the group that Ultrasonography did not show metastasis. There were noother associations between central region lymph node metastasis and other clinicopathologicalparameters. Logistic regression analysis showed extrathyroidal invasion andUltrasonography showed lymph node metastasis were risk factors for central region lymphnode metastasis.2. Papillary thyroid carcinoma those who were in the groups of male,＜45years old，unilateral tumor had a higher rate of lateral cervical lymph node metastasis. And thegroup of central region lymph node metastasis had a higher rate of lateral cervical lymph nodemetastasis than the group of without central region lymph node metastasis. There were noother associations between lateral cervical lymph node metastasis and otherclinicopathological parameters. Logistic regression analysis showed central region lymphnode metastasis was a risk factors for lateral cervical lymph node metastasis.3.Thoseclinically negative central lymph nodes metastasis papillary thyroid carcinoma who were inthe groups of the diameter>1cm, not associated with nodular goiter had a higher rate ofcentral region lymph node metastasis. There were no other associations between lateralcervical lymph node metastasis and other clinicopathological parameters.4. Thoseclinically negative lateral cervical lymph node metastasis papillary thyroid carcinoma who inthe group of central region lymph node metastasis had a higher rate of lateral lymph nodemetastasis than the group of without central region lymph node metastasis. There were noother associations between lateral cervical lymph node metastasis and otherclinicopathological parameters.[Conclusion]1. For papillary thyroid cancer，the most common cervieal lymph nodemetastasis is central region．It is necessary to dissect central region lymph node following theoriginal surgical procedure.2. If preoperative clinical examination demonstrate lateral cervicallymph node metastasis,we should practice lateral cervical lymph node dissection;Ifpreoperative clinical examination did not demonstrate lateral cervical lymph nodemetastasis,we should practice periodically review instead of lymph node dissection.3. Therewas significant association between central region lymph node metastasis and lateral cervicallymph node metastasis. It is necessary to dissect lateral cervical lymph node in the cases of central region lymph node metastasis.4. Ultrasound examination could guide the choice forneck lymph node dissection.