| Objectives:To analyze the risk factors affecting cervical lymph node metastasis of papillary thyroid carcinoma(PTC).Methods:We collected the clinical data of 202 patients who were diagnosed firstly as and treated in the Department of Head an dNeck Surgery of Affiliated Tumor Hospital of Guangxi Meidical U niversity,from July 2002 to June 2016.All patients underwent cervi cal lymph node dissection,among whom 93 patients underwent central and lateral neck lymph node dissection,and 109 underwent central neck lymph node dissection.Using univariate and multiv ariate,we valuated the associations of the lymph node metastasis r isks with some clinical factors including-sex,age,unilateral or bilateraltumor,tumor size,mulifocality,microcarcinoma,preoperative periphe ral platelet count,chronic systemic diseases,smoking history,drinking history.U nivariate analysis were performed using X~2 test,and those f actors which were with the corresponding P less than 0.1,were inc luded in the following multivariate analyses using the binary logisti c regression model.All P values less than 0.05 were considered sign ificant,referring to two-sided tests.Results:therewere96 patients who had cervical lymph node met astasis among all of the 202 patients.Univariate analysis showed tha t male(X~2=4.589,P=0.032),age(X~2=11.384,P=0.001),unilateral or bilater al tumor(X~2=9.700,P=0.002),microcarcinoma(X~2 =8.020,P=0.005),pl atelet count(X~2=7.980,P=0.005)were significantly related to cervical lymph node metastasis in papillary thyroidcarcinoma.And multivariat e analysis of binary logistic regression analysis showed thatmale(P=0.045,OR=0.461,95%CI=0.216-0.984),age(P=0.004,OR=0.357,95%C I=0.176-0.726),unilateral or bilateral tumor(P=0.001,OR=6.610,95%CI=2.280-19.169),platelet-count(P=0.005,OR=3.282,95%CI=1.438-7.491),microcarcinoma(P=0.001,OR=0.215,95%CI=0.083-0.555)were indepe ndent factors affecting lymph node metastasis.In the study analyzing lateral neck lymph node metastasis risk of patients who had centr al lymph node metastasis,the results from univariate analysis sho wed that male(X~2=5.800,P=0.016),age(X~2=9.896,P=0.002)was related to the lateral neck lymph node metastasis,respectively,and t he data of multivariateanalysis showed that male(P=0.0426,OR=0.199,95%CI=0.048-0.827)and age(P=0.002,OR=0.153,95%CI=0.046-0.516)were independent factors influencing lateral neck lymph node m etastasis risk.In the analysis of 40 papillary thyroid mricrocarcinoma patients,we found that unilateral or bilateral tumorwas significantly r elated to the cervical lymph node metastasis(X~2=7.343,P=0.007).In the analysis involving 84 cN0 PTC patients,we found that preoperat ive platelet count was significantly related to the cervical lymph no de metastasis(X~2=5.411,P=0.020).Conclusions:male,age?45 years,bilateral tumor,platelet count>300×109/L,tumor size>1cm were risk factors for lymph node metast asis in PTC.For the patients with central lymph node metastasis,male and age?45 yearswere independent risk factors for lateral neck lymph node metastasis.bilateral tumorwas related to the cervical ly mph node metastasis on papillary thyroid microcarcinoma.Preoperati ve platelet count was related to the cervical lymph node metastasis in cN0 PTC. |
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