Influence Factors And Operation Cleaning Scope Of Cervical Lymph Node Metastasis On Papillary Thyroid Micro Carcinoma

Objective:Analysis of the papillary thyroid micro carcinoma central and lateral cervical lymph node metastasis characteristics and influence factors.Explore papillary thyroid micro carcinoma operation cleaning scope.For cleaning scope and pointer of cervical lymph node in surgery provides an objective basis.Methods : All patients were acquired from July,2015 to March,2016 in The People's Hospital of Sichuan Province undergoing surgical treatment due to suffer from papillary thyroid micro carcinoma.They all clean the central lymph node after removing the thyroid,once the intraoperative pathological result confirms the central lymph node having metastasis,cleaning the lateral cervical lymph node.Collect the above patients' clinical data.SPSS 19.0 software was applied for statistical data analysis of the cervical lymph node metastasis characteristics of PTMC patients.Explore the relation between age,gender,tumor size,number of lesions,distribution,Anti-Tg,Anti-TPO with the metastasis of lymph node and postoperative complications with different cleaning scope and the influence of central group lymph node metastasis on the lateral cervical lymph node metastasis.Results: In 129 cases of PTMC patients who cleaning the central cervical lymph node,there are 67 cases have the central lymph node metastasis.The central cervical lymph node metastasis rate is51.94%.In the 67 cases,there are 48 cases cleaning the lateral lymph node of affected side.Theultima paraffin pathologies confirm 29 cases having the lateral lymph node metastasis,lateral metastasis rate is 60.42%.When the central lymph node have1 and 3 metastasize,the lateral metastasis rate is 14.2% and 70%(P=0.010),the lateral metastasis rate will rise when the number of central lymph node metastasis goes up.In the cases who have lateral metastasis,II,III,IV,V district lymph node metastasis rate is 12.5%,37.71%,35.29%,16.00%(P=0.041).Male and female central lymph node metastasis rate is 60% and48.49%,(P=0.047);Male lateral lymph node metastasis rate is 86.67,obviously higher than the female who is 48.49%,(P=0.024).Age older than 45 central lymph node metastasis rate(42.03%)is lower than age youger than45(63.33%),(p=0.016),PTMC central lymph node metastasis contains the younger trend,different age patients have the similar lateral lymph node metastasis rate(p=0.597).The central lymph node metastasis rate of single lesion patients is 47.73%,which is lower the multiple lesions ones 60.98%(p=0.0461).Only have multiple lesions in one side of neck,its lateral lymph node metastasis rate is higher than the both sides(p=0.024).Patients with tumor diameter less than 0.5cm and patients with tumor diameter between 0.5 and1.0cm the central lymph node metastasis rate are26.67%,59.60%,(p=0.002).The influence of lesion location and Anti-Tg,Anti-TPO on the cervical lymph node metastasis has no statistical significance.Multi-factor analysis shows that the lesion size and age are independent factors affecting central lymph node metastasis.Central lymphnode metastasis and metastasizing numbers are independent factors affecting lateral lymph node metastasis.There no one case has occurred permanent complications,but some patients appear temporarily low parathyroid function.Conclution: PTMC patients who obtain following factors :Male,young age,multiple lesions,the lesions with lager diameter,are easier to appear central lymph node metastasis.younger patients has a rising trend on central lymph node metastasis rate.Patients who having following factors :Male,multiple lesions in one side of neck,central lymph node metastasis,are more likely to occur lateral lymph node metastasis.The metastasizing numbers of central lymph node have a positive effect on forecasting the metastasis rate of lateral lymph node.When the metastasizing number of central lymph node are more than 3,the metastasis rate of lateral lymph node will obviously rise.The PTMC patients should be regular cleaning the central lymph node.The PTMC patients who have provide central lymph node metastasis could be considered primary factor to cleaning lateral cervical lymph node,if possible,the major factor to cleaning lateral cervical lymph node should conside as the numbers of entral lymph node metastasis,meanwhile,evaluate it with gender and size of tumor.Doctors cleaning cervical lymph node doesn't increase surgical complication in abundant surgical operations.