Retrospective Clinical Analysis Of The Regularity Of Cervical Lymph Node Metastasis In Papillary Thyroid Carcinoma

Objective To investigate the regularity of cervical lymph node metastasis of Papillary thyroid carcinoma(PTC),and to provide clinical reference data for the planning of surgical procedures for patients with cervical lymph node dissection of PTC.Methods The clinical data of 94 patients with papillary thyroid carcinoma who underwent total thyroidectomy combined with central and lateral cervical lymph node dissection were retrospectively analyzed and admitted to the Department of Thyroid Surgery of the Second Affiliated Hospital of Fujian Medical University on September 1,2018 and December 31,2020.Statistics of the age,sex,tumor size,tumor location,pathological type,jumping transfer cases,cleaning the number of lymph node in central region,the central lymph node metastasis(cases/number),the lymph node zone II-V number,II-V zone of lymph node metastasis(cases/number),and USES the single factor analysis method research the correlation between clinical pathological factors and cervical lymph node metastasis,and then USES the logistics multi-factor analysis independent risk factors for cervical lymph node metastasis.Results 1.The study results showed that among the 94 patients in this group,the central lymph node metastasis rate was 87.23%(82 cases),the skipping metastasis rate was about 12.77%(12 cases),the II zone metastasis rate was 70.21%(66 cases),the III zone metastasis rate was 80.85%(76 cases),the IV zone metastasis rate was 56.38%(53cases),and the V zone metastasis rate was 20.21%(19 cases).2.Univariate analysis showed that the number of lymph node metastases in the central region was correlated with tumor size(P=0.016).The rate of lymph node metastasis in zone II was correlated with tumor location(upper,middle/lower)(P=0.024).The number of lymph node metastases in zone II was correlated with age(P=0.037),sex and pathological type(P=0.011).The rate of lymph node metastasis in zone III was correlated with gender(P=0.012),and the above differences were statistically significant(P < 0.05).3.Multivariate analysis showed that tumor location(upper,middle/lower)was an independent risk factor for zone II lymph node metastasis rate,and tumor location at the upper pole was an independent risk factor for zone II lymph node metastasis rate in patients with papillary thyroid carcinoma.Gender was an independent risk factor for zone III lymph node metastasis,and male patients were an independent risk factor for zone III lymph node metastasis in papillary thyroid carcinoma.4.Skipping metastasis was not correlated with age,sex,tumor size,tumor location and pathological type,and the difference was not statistically significant(P > 0.05).Conclusion In conclusion,II,III,IV and VB areas should be included in the lymph node dissection of the lateral cervical region of thyroid cancer.For patients with tumor diameter > 1cm,special attention should be paid to whether the central lymph node dissection is complete.Patients with tumors located in the upper pole,male,age ≤45years old,or pathological classification of high-cell subtype should pay attention to zone II lymph node dissection during operation.At the same time,men should also focus on dissection of zone III lymphatic.