Analysis Of Risk Factors For Cervical Lymph Node Metastases In Papillary Thyroid Microcarcinoma

Objective : To analyze the pathological characteristics of thyroid cancer and the changes in the constituent ratio of patients received surgical therapy from Affiliated Hospital of Jining Medical University last 7 years.To analyze the risk factors for cervical lymph node metastasis of papillary thyroid micro-carcinoma.Methods:1.The clinical data of patients received surgical therapy with pathologically confirmed findings were collected from 2008 January to December 2014.The constituent ratio of thyroid diseases and thyroid tumor among different population groups in different years were analyzed.2.Data of the pathological features 289 patients with PTMC who were treated between January 2013 and December 2014 were retrospectively analyzed.Risk factors for cervical lymph node metastasis were analyzed by multiple regression analysis.Results:1.The number of patients with thyroid disease admitted hospital have had increased significantly in the past 7 years.Thyroid cancer have the faster growing than nodular goiter.The composition ratio of thyroid cancer increased from 13.6% to39.6% in the past 7 years.The overall proportion of nodular goiter is still at the leading position,but it have had decreased slowly.The composition ratio of papillary thyroid carcinoma is maintained at a relatively high level,however the composition ratio of papillary thyroid micro-carcinoma increased significantly,which has increased from 22.8% to 58.0% from 2008-2014.2.There were 350 cases of papillary thyroid micro-carcinoma,289 cases of Primary lesion resection using thyroid glandular glandular +isthmus or full / near total thyroidectomy + cervical lymph node dissection,postoperative pathology confirmed central area lymph node metastasis rate 40.8%(118/289),from 2013 January to December 2014.64 cases of PTMC underwent central area lymph node and lateral neck lymph node dissection,27 cases(42.2%)occurred lateral cervical lymph node metastasis.3.289 cases of PTMC patients underwent central lymph node dissection.Univariate analysis showed that lymph node metastasis in central area was related totumor diameter,primary lesion number,single and bilateral cancer and capsule invasion(all P <0.05).Multivariate analysis found that central area Lymph node metastasis was only related to tumor diameter(P <0.05).4.This study through the smooth curve fitting chart clearly shows that the risk of lymph node metastasis in the central area is significantly increased when the maximum diameter of the tumor is greater than 6 mm.The multivariate regression analysis showed that the tumor diameter was> 6 mm(OR = 2.06,95% CI = 1.17 to3.62,P = 0.0118)was an independent risk factor for central lymph node metastasis.5.64 cases of PTMC underwent central area lymph node and lateral neck lymph node dissection.Univariate and Multivariate analysis showed that central compartment metastasis were associated with the lateral lymph node metastasis.Multiple regression analysis showed that the central lymph node metastasis(OR = 13.92,95% CI = 1.32 ~ 146.8,P = 0.0285)were independent risk factors for lateral cervical lymph node metastasis.Conclusion:Thyroid disease and tumor pathological types had dramatically changed in hospitalized patients.The occurrence of thyroid carcinoma,especially papillary micro-carcinoma has been increasing.PTMC patients with central or lateral cervical lymph node metastasis is very common,PTMC tumor diameter is the central area of lymph node metastasis independent risk factors,diameter> 6 mm when the central area of the risk of lymph node metastasis will increase 1.06 times;central lymph node metastasis Patients,lateral cervical lymph node metastasis risk will increase 13 times.