Related Factors Analysis For Lateral Lymph Node Metastasis In Papillary Thyroid Carcinoma With Suspicious Preoperative Imaging Findings

Objective:In this study,we analyzed the influencing factors of lateral lymph node metastasis(LLNM)by observing preoperative ultrasound suspicious LLNM in patients with thyroid papillary carcinoma(PTC).To further explore the diagnostic value of ultrasound for LLNM.Methods:Retrospective analysis of 518 patients with PTC confirmed by surgical pathology from January 2017 to June 2018 According to the postoperative pathology,179 patients with PTC who were suspected of preoperative ultrasound LLNM were divided into the lateral lymph node metastasis group(LLNM group)and the non-lateral lymph node metastasis group(NLLNM group).Analysis and summary of clinical pathological features and ultrasound sonographic features between the two groups,Chi-square test/t test and the Multi-factor logistic regression analysis were used to analyze the risk factors.Results:(1)Among 518 patients with PTC,189 patients with lymph node metastasis(LNM)confirmed by pathology,179 patients with PTC in the LLNM before operation,there were 79 cases in the lateral lymph node metastasis group(LLNM group)and 82 cases in the non-lateral lymph node metastasis group(NLLNM group);(2)Univariate analysis showed that gender(P=0.002),tumor diameter(P<0.001),CLNM(P<0.001),multifocal nature(P=0.048),capsule invasion(P=0.006),microcalcification in primary lesion(P<0.001),nodule aspect ratio>1(P=0.017)were statistically significant between the two groups;(3)Multivariate logistic regression analysis showed: male(P=0.002),tumor diameter(P=0.011),CLNM(P<0.001),microcalcification in primary nodules(P<0.001),membrane invasion(P=0.016)was an independent risk factor for LLNM in the PTC neck;(4)The truncation point of the tumor diameter was predicted by ROC curve to predict the LLNM: the cut-off point on the tumor diameter curve was 1.1 cm,and the sensitivity was 54%.The specificity was 74%,that is,1.1 cm was used as a critical value for dividing the relationship between tumor diameter and LLNM.Conclusion:Male,tumor diameter ≥1.1cm,CLNM,primary calcification in the nodules,and membrane invasion are associated with LLNM.When ultrasound findings of suspected malignant thyroid lesions with the above ultrasound signs and clinical features The lateral lymph nodes should be carefully examined.