Analysis Of Related Factors Of Cervical Lymph Node Metastasis In Thyroid Papillary Microcarcinoma

Part 1: Analysis of Related Factors of Central Regional Lymph Node Metastasis in Thyroid Papillary MicrocarcinomaObjective To investigate the related factors of central regional lymph node metastasis(CLNM)in patients with papillary thyroid microcarcinoma(PTMC)and explore the optimal critical value of tumor diameter in predicting central lymph node metastasis.Methods The clinical and pathological features of 550 cases of papillary thyroid carcinoma with clinical lymph node negative(c N0)were retrospectively analyzed.?~2test and multivariate logistic regression analysis were used to analyze the related factors of CLNM.The ROC curve was used to analyze the tumor diameter and CLNM of PTMC.Results The CLNM rate was 35.6%.Univariate analysis showed that the age of the patients was less than 45y(?~2=13.983,P<0.001),the diameter of tumor?7 mm(?~2=14.263,P<0.001),capsule invasion(?~2=7.316,P=0.006),multifocality(?~2=14.321,P<0.05)and bilateral(?~2=9.265,P=0.002).Multivariate Logistic regression analysis showed that age <45y,diameter of tumor?7mm,invasion of capsule and multifocal is an independent risk factor for CLNM in patients with PTMC.The optimal cutoff value of CLNM by diameter is 8mmConclusion The CLNM of PTMC is related to many factors.When the age of the patient is less than 45 y,the diameter of the tumor is more than 7mm,the invasion of the capsule and the multifocal lesion,the higher the risk of central lymph node metastasis and the central lymph node dissection should be performed.Part 2: Analysis of Related Factors of Lateral Neck Lymph Node Metastasis in c N0 Papillary Thyroid MicrocarcinomaObjective To investigate the risk factors of cervical lateral lymph node metastasis(LLNM)in the papillary thyroid microcarcinoma(PTMC)and to provide evidence for the lymph node dissection in PTMC.Methods The preoperative color Doppler echocardiography and clinicopathologic features of 462 patients with clinical lymph node negative(c N0)papillary microcarcinoma were retrospectively analyzed.Chi-square test and logistic regression analysis were used to analyze the risk factors and lateral region lymph node metastasis.Results In the present study,the rate of lymph node metastasis in the central region of thyroid papillary microcarcinoma was 38.5% and the rate of lateral lymph node metastasis was 23.6%.Gender(?~2= 7.312,P<0.05)?tumor diameter(?~2= 14.321,P <0.001),invasion of the capsule(?~2= 21.689,P <0.001),multifocal carcinoma(?~2= 13.086,P <0.05)?tumor location(?~2= 19.028,P <0.001)and central lymph node metastasis(?~2= 69.421,P<0.001)were significant correlation with lateral lymph node metastasis(P <0.05).multivariate logistic regression analysis Show sex,tumor diameter,invasion of the capsule,multifocal,central lymph node metastasis were independent risk factors for PTMC patients with lateral lymph node metastasis.The number of lymph node metastasis in the central region is a high risk factor of lymph node metastasis in the lateral cervical region.Conclusions Lateral cervical lymph node metastasis of thyroid papillary microcarcinoma is associated with a number of factors.Male patients with tumor located in the upper pole and central lymph nodes metastasis are more likely to the lateral cervical lymph nodes metastasize.