Factors Of Cervical Lymph Node Metastasis On Papillary Thyroid Microcarcinoma

Objective:To discuss the clinical law and impact factor of the thyroid papillarymicrocarcinoma lymph node metastasis to provide a theoretical basis forthe range of neck dissection.Method:All882cases were acquired from thyroid surgery department ofChina-Japan Union Hospital of Jilin University from January2012toDecember2012undergoing surgical treatment with confirmed papillarythyroid microcarcinoma paraffin pathology. Their clinical data andpreoperative FNA biopsy, intraoperative and postoperative pathologicalresults were statistically analyzed.SPSS19.0software was applied forstatistical data analysis. We retrospectively investigated the influence ofage, gender, tumor size, number of lesions, thyroid function,FNAbiopsy, capsular invasion in central and lateral cervical lymph nodemetastasis,and the relationship of central group lymph node metastasisand lateral cervical lymph node metastasis,and postoperativecomplications;to summarize the clinical law of the cervical lymph nodemetastasis after all.Results:In882cases of papillary thyroid microcarcinoma,lymph node metastasis rate of29.6%, in which central and lateral neck metastasis ratewas26.4%and15.2%. Male and female central neck lymph nodemetastasis rate were24.4%and14.5%(P=0.001); lateral metastasis ratewere22.8%and15.1%(P=0.001). Age≤30years old and age>30yearsold central neck lymph node metastasis rate were31.0%and15.7%(P=0.002); lateral metastasis rate were27.6%and14.2%(P=0.006). Age≤45years old and age>45years old central neck lymph node metastasisrate were20.6%and10.8%(P <0.001); lateral metastasis rate was17.4%and11.6%(P=0.019). Tumor diameter≤0.5cm and0.5cm <diameter≤l cm central neck lymph node metastasis rate were11.1%and23.5%(P<0.001); lateral metastasis rate were9.2%and22.3%(P <0.001). Singleand multifocal central neck lymph node metastasis rate were14.3%and21.9%(P=0.004); lateral metastasis rate were11.3%and23.4%(P<0.001). Preoperative PTH value of cases with or without central necklymph node metastasis rate were （48.85±18.58）pg/ml and （51.89±24.22）pg/ml (P=0.017). Fine-needle aspiration cytology positive ratewas94.02%. Central neck lymph node metastasis rate of cases with orwithout capsular invasion were14.15%and60.42%(P <0.001); lateralmetastasis rate were13.55%and41.67%(P <0.001). The rate that Laterallymph node metastasis occurred with or without central neck metastasiswas8.44%and51.82%(P <0.001). Conclusion:Thyroid papillary microcarcinoma central lymph node metastasiswas common in male, younger, multifocal, large-size andcapsule-invaded cases;lateral lymph node metastasis was common inmale, younger, multifocal, large-size and capsule-invaded cases. wasCentral lymph node metastasis was the most frequent metastasis area inthyroid papillary microcarcinoma,followed by lateral lymph node. Indeveloping the range of indications and lymph node dissection Surgeonshould fully assess the impact of risk factors of lymph node metastasiswhen formulating the range and indication of lymph node dissection andmake out an individualized strategy.