The Risk Factors Of Iymph Node Metastasis In Differentiated Thyroid Carcinoma

Objective:The goals of this study was to investigate the clinicopathological features of differentiated thyroid cancer (DTC),and then to examine the relationship between clinicopathological features and lymph node metastasis(LNM) to determine the risk factors.Method:We selected all the patients diagnosed differentiated thyroid cancer from Nanjing Jinling hospital between February 2010 and October2015.All of the patients underwent surgery, and the operation was total thyroidectomy or thyroid lobectomy as well as neck lymph node dissection. A total 302 differentiated thyroid carcinomas had lymph node metastasis. The relationship between clinicopathological features and the lymph node metastasis was analyzed to determine the risk predictor of LNM. Based on the clinicopathological features we derived a scoring system.To determine the predictive accuracy of the scoring system for LMN among DTC, all the patients diagnosed DTC between January 2016 and March 2016 was selected to evaluate the risk of lymph node metastasis. The postoperative pathological diagnosis was the standard to judge the accuracy.Results:Comparing lymph node metastasis group and control group,the former had younger age and larger tumor diameter. Both in study group and control group, the TSH level was in the normal range, and TG-Ab was higher than the normal range. Gender, younger than 45 years old, tumor diameter larger than one centimetre. calcifications, invasion of glandular capsule and mulifocality were independent risk factors of thyroid cancer lymph node metastasis. The scoring system of lymph node metastasis based on the retrospective analysis has good prediction effect.It helps clinicians to choose the most appropriate surgical procedure after preoperative and intraoperative evaluation of cervical lymph node.Conclusion:For people undergo thyroidectomy, we should evaluate the risk of cervical lymph node metastasis. For patients with high-risk cervical lymph node metastasis, even clinical lymph node was negative, we could recommend prophylactic neck lymph node dissection. TSH, thyroglobulin antibodies level, pathological classification have no statistical significance in this study. But thyroglobulin antibodies level may be related to the occurrence of thyroid carcinoma.