Study On The Correlation Between Clinical Features Of Papillary Thyroid Carcinoma,P53,Ki-67 And Cervical Lymph Node Metastasis

Part one Study on the correlation between clinical features of papillary thyroid carcinoma and cervical lymph node metastasisObjective: By analyzing the clinical data of patients with thyroid papillary carcinoma,to find out the risk factors affecting cervical lymph node metastasis of papillary thyroid carcinoma,as a reference for surgeon to formulate individualized surgical regimens and to assess the prognosis.Methods: Collected from August,2014 to August,2016 in Hebei General Hospital gland surgery treated by postoperative paraffin pathology results confirmed papillary thyroid carcinoma patients,be retrospectively analyzed.Grouped according to factors that may affect the patient’s cervical lymph node metastasis.SPSS 21.0 statistical software was used to analyze the results,P<0.05 was considered statistically significant difference.To analyze the correlation between these factors and the lymph node metastasis in the central compartment(level Ⅵ)and the lymph node metastasis in the cervical compartment,to verify the accuracy of cN0 standard.Results: The lymph node metastasis rate of level Ⅵ in 216 patients with papillary thyroid carcinoma were significant differences between gender,age,tumor size,number of foci,thyroid capsule invasion and tumor involving single and bilateral glands(P<0.05).68 patients were underwent lateral cervical lymph node dissection,lateral cervical lymph nodes metastasis were not concerned with gender,age,tumor size,number of foci,thyroid capsule invasion and tumor involving single and bilateral glands,but concerned with the number of level Ⅵ lymph node metastasis,the lateral cervical lymph node metastasis rate of patients with level Ⅵ lymph node metastasis ≥3 was significant higher than patients with level Ⅵ lymph node metastasis<3(P=0.043).In the lateral cervical compartment,the metastasis rate was highest in level Ⅲ(41.9%),followed by level Ⅱ(38.7%)、level Ⅳ(32.3%)and levelⅤ(6.5%).According to the current cN0 standard diagnosis of lateral cervical lymph node metastasis misdiagnosis rate of 25.0%.Part two Study on the correlation between P53 and Ki-67 and cervical lymph node metastasisObjective: The expression of P53 and Ki-67 in papillary thyroid carcinoma with or without lymph node metastasis was detected by immunohistochemistry,to analyze whether it affects the occurrence of lymph node metastasis of thyroid papillary carcinoma.Methods: 29 papillary thyroid carcinoma patients with level Ⅵ lymph node metastasis and 30 papillary thyroid carcinoma patients without level Ⅵlymph node metastasis from August 2014 to August 2016 were randomly selected,further grouping according to tumor diameter,the expression of P53 and Ki-67 in each group was detected by immunohistochemistry.SPSS 21.0statistical software was used to analyze the results,P<0.05 was considered statistically significant difference.Results: There was no significant difference in the positive rate of P53 protein between sex,age,tumor size,invasion and number of foci in primary papillary thyroid carcinoma of 59 patients(P>0.05).There was no significant difference in the positive rate of Ki-67 between sex,age,thyroid capsule invasion and number of foci in primary papillary thyroid carcinoma of 59patients(P>0.05).However,positive rate of Ki-67 protein is related to tumor size,the positive rate of patients whose tumor diameter>1cm was higher than those whose tumor diameter>1cm(P<0.05).There was no significant difference in the expression of P53 and Ki-67 protein between the metastasis group and the no transferred group(P>0.05)in 59 cases of papillary thyroid carcinoma(including papillary carcinoma).The expression of P53 and Ki-67 protein was not significantly different in 14 cases of central papillary carcinoma with central lymph node metastasis and 15 cases with maximal diameter>1cm but no central lymph node metastasis(P>0.05).Conclusions:1 The rate of level Ⅵ lymph node metastasis in thyroid papillarycarcinoma(include papillary thyroid microcarcinoma)is high,initial operation should be routine central lymph node dissection.2 Male,<45 years of age,tumor invasion of thyroid capsule,the maximum diameter of foci >1cm,multifocal,foci involving bilateral glands are the high risk factors of lymph node metastasis in the central compartment of thyroid papillary carcinoma..3 The number of lymph node metastases in level Ⅵ≥3 was the risk factor of lymph node metastasis in lateral cervical region,it can be used as a reference for lateral lymph node dissection.4 The current cN0 standard for the determination of lateral cervical lymph node metastasis is still inadequate,should be carefully treated with its diagnostic results.5 The expression of P53 and the expression intensity of Ki-67 protein in thyroid papillary carcinoma(include papillary thyroid microcarcinoma)was not associated with lymph node metastasis.