| Objective: Due to the lack of an accurate preoperative diagnostic method of central lymph node metastasis (CLNM) of papillary thyroid carcinoma (PTC), the prophylactic central lymph node dissection remains controversial. The present study investigated the clinicopathological features of PTC patients and the risk factors of CLNM.Methods: The clinicopathological features of PTC patients with respect to gender,age,initial symptoms, observation, tumor diameter, multifocality, extrathyroidal invasion, and pathological data combined with other thyroid diseases, were analyzed retrospectively. The risk factors of CLNM were analyzed by ?2 test and multivariate logistic regression model.Results: The CLNM rate of PTC was 40.6% (1331/3273). On average, 7.0(4.0,12.0)central lymph nodes were dissected,and 3.70( ± 3.84)lymph nodes were proved to be metastatic. Univariate analysis showed that gender (P < 0.001), age (P <0.001), tumor diameter (P < 0.001), extrathyroid invasion (P < 0.001), multifocality(P = 0.001), concurrent nodular goiter (P < 0.001), initial symptoms (P < 0.001), and observation or not (P < 0.001) were related to CLNM. The observation time was neither related to CLNM (P = 0.469) nor extrathyroidal invasion (P = 0.137). Tumors localized in the lower part of the thyroid were the risk factors for CLNM (P < 0.001)while multifocality was unrelated (P = 0.68). The metastasis rate of bilateral multiple regions > unilateral multiple regions > single region (P = 0.003). Multivariate logistic regression analysis showed that gender, age, tumor diameter, extrathyroidal invasion,and observation were independent risk factors of CLNM.Conclusions: Male, younger age, large tumor size, and extrathyroidal invasion were independent risk factors for CLNM. CLNM was related to multiple regions occupied by tumors in the thyroid but unrelated to multifocality. The tumor occupying a single region and localized in the lower part of thyroid could be used as a predictive factor for CLNM. For tumors that could not be diagnosed as benign or malignant,observation may be an option,since no evidence of disease progression was presented during observation.Objectives: To investigate the predictive factors of lymph node metastasis of deep surface (rVIb) of the right recurrent laryngeal nerve (rRLN) in papillary thyroid microcarcinoma (PTMC) patients, and the correlation between rRLN superficial surface (rVIa) and rVIb lymph node metastasis in these patients.Methods: Based on metastasis in rVIb, 772 PTMC patients admitted to our hospital from July 2013 to June 2016 were divided into two groups. ?2test and multivariate logistic regression were used to analyze the risk factors of rVIb metastasis. P < 0.05 indicated statistically significant differences.Results: The r?b metastasis rate was 7.1% (55/772). Univariate analysis showed that the factors that correlated with rVIb metastasis were gender (P<0.001), age (P=0.005),tumor size (P=0.0 18),tumor location (P=0.008),extrathyroid invasion (P<0.001),metastasis of left central area (l?) - rVIa (P<0.001), lateral lymph node metastasis(LLNM) (P<0.001), combined with nodular goiter (P=0.035), the right tumor location(P=0.014), rVIa lymph node metastasis (P<0.001), and metastasis number (P<0.001)and ratio (P<0.001). Mulifocality (P=0.881), right mulifocality (P=0.693), combined with Hashimoto's disease (P=0.971) were not relevant. Multivariate analysis showed that male, extrathyroid invasion, rVIa metastasis, LLNM and right tumor region were independent predictive factors of rVIb.Conclusions: Male, extrathyroid invasion, rVIa lymph node metastasis, LLNM and right tumor location in the upper part were independent risk factors of rVIb metastasis.rVIb metastasis was positively correlated with the number and ratio of rVIa metastatic lymph nodes. The risk of lymph node metastasis in rVIb was increased by 8.4 times and by 10.9 times when the metastatic lymph node ?2 and metastasis ratio of rVIa was >60% respectively. Patients with high risk in rVIb should be chosen for more complete rVIb including central lymph node dissection (CND). |
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