Value Of Clinicopathological Features In Predicting The Metastasis Of Lateral Cervical Lymph Nodes In Thyroid Papillary Carcinoma With BRAFV600E Mutation

Purpose To assess the relationship between the clinicopathological features of papillary thyroid carcinoma with BRAFV600 E mutation and lateral lymph node metastasis,to analysis the diagnostic efficiency of papillary thyroid carcinoma with BRAFV600 E mutation in predicting lateral lymph node metastasis,and to investigate auxiliary effect of papillary thyroid carcinoma with BRAFV600 E mutation in predicting lateral lymph node metastasis.To investigate the value of clinical and pathological features of papillary thyroid carcinoma with BRAFV600 E mutation in predicting lateral lymph node metastasis.Methods Retrospective analysis of 279 cases of thyroid surgery same treatment of fujian medical university union hospital group in December 2016 to October 2017 admitted confirmed by surgery pathology for BRAFV600 E mutation type patients with thyroid papillary carcinoma,basic clinical data and pathological results complete record(including gender,age,tumor diameter,largest presence with hashimoto,tumor single/multiple,presence of capsule involvement,with and without lymph node metastasis),measurement data using t test,counting data by chi-square test.Multi-factor analysis of Logistic regression model is established,and the lateral analysis have be transferred to the standard,ROC Curve drawing,calculate the Area Under the Curve(Area Under the Curve,AUC)and determine the diagnosis of cancer that has spread to the side was the best value,and get a degree of sensitivity,specific and evaluate the diagnostic performance,discusses its application in predicting tumor side was transfer value.Results 1.Univariate analysis of age distribution showed no significant difference in the metastasis of the lateral cervical lymph node(t=1.194,P=0.074);There was a significant correlation between the gender,the maximum size of the tumor,whether there was a membrane invasion,the tumor single/multiple hair,whether there was a combination of hashish,whether there was metastasis in the central region,and there was no lateral cervical lymph node metastasis in the tumor.2.The multi-factor Logistic regression analysis results show that the largest tumor diameter(OR = 1.804,P = 1.804),the capsule invasion situation(OR = 4.582,P = 4.582),the central transfer situation(OR = 4.442,P = 4.442)were significantly associated with cancer that has spread to the side of the neck,sex,tumor and multiple and hashimoto have no significant correlation with lateral neck metastasis,P > 0.05).By the OR value,the tumor every increase 1 mm,maximum diameter,the increase in the risk of lateral analysis transfer 0.804 times more likely to be film side of the assault group was transferred risks are not assault group 4.582 times,the central transfer group turn risk of lymph node metastasis is no transfer group was 4.422 times.Therefore,the increase of tumor maximal diameter,membrane metastasis and metastasis of central region can increase the risk of lateral cervical lymph node metastasis.3.According to the above prediction model,Logit(p)=0.590* tumor maximum diameter(cm)+1.522* membrane invaded(0/1)+1.487* central region metastasis(0/1)-6.439;Furthermore,the probability P=exp[Logit(p)]/1+exp[Logit(p)] was calculated.4.Tumor diameter,largest presence of capsule violations,the central presence of transfer analysis to predict tumor side transfer have diagnostic value(p < 0.05),among them to predict lateral transfer analysis of diagnosis efficiency highest is biggest tumor diameter(AUC = 0.677,p = 0.008);To predict the probability values draw ROC curve prediction model,the results show that the prediction model to predict the diagnosis of cancer that has spread to the side was more efficient(AUC = 0.850,p < 0.001),the best diagnostic value of 0.1212,the sensitivity of 80.0%,specific degrees 82.3%,have high clinical application value.Conclusion 1.In the patients with BRAFV600 E mutated thyroid papillary carcinoma,the maximal diameter of the tumor,the invasion of the membrane and the lymph node metastasis in the central region are the independent risk factors for predicting the metastasis of the lateral cervical lymph nodes.2.Prediction model in predicting BRAFV600 E mutation in patients with thyroid papillary carcinoma lateral analysis have higher clinical value in the transfer,can provide reference for the clinical decision and follow-up management of BRAFV600 E mutation patients with thyroid papillary carcinoma.