The Analysis On The Risk Factors For Central Lymph Node Metastasis Of Multifocal Papillary Thyroid Carcinoma

Objective:To determine the clinical and pathological features and the risk factors that increase the neck central lymph node metastasis in multifocal papillary thyroid carcinoma(MPTC).Method:In this retrospective study,clinical and pathologic data were collected from 1054 patients who were first diagnosed as PTC at the Xinjiang Medical University affiliated Tumor Hospital from January 2016 to December 2016.To compare the differences of clinical and pathology features between multifocal group and single focal group.Chi-square test and multivariate logistic regression analysis were used to identify the risk factors of the neck central lymph node metastasis in MPTC.Result:There was no significant difference in age,gender,Hashimoto's thyroiditis,Nodular goiter and calcification between the two groups.The incidence of papillary thyroid microcarcinoma(PTMC)in multifocal papillary thyroid carcinoma is lower than that of single focal group,However,central lymph node metastasis was significantly different between the two groups(?~2=59.399,P=0.000).The capsule invasion rate in the multifocal group were greater than those in the single focal group.And the stage of disease in the multifocal group was later than that in the single focal group(P<0.05).Of all MPTC patients,50.6%had the neck central lymph node metastasis.Family history,the number of lesions greater than 2 or the combination of Hashimoto's thyroiditis were significantly correlated with the neck central lymph node metastasis(P<0.05).Multivariate logistic regression analysis indicated that the number of lesions greater than 2 and the combination of Hashimoto's thyroiditis were independently correlated with the neck central lymph node metastasis.Conclusion:The incidence ofPTMC in multifocal papillary thyroid carcinoma is lower than that of single focal group,the disease stage of multifocal thyroid cancer was later than that of unifocal cancer,with easy membrane invasion,more prone to lymph node metastasis.The multifocal features can be used as one of the predictors of PTC lymph node metastasis.More aggressive treatment or more frequent follow-up could be considered for patients with unfavorable features(the number of lesions greater than 2,combination of Hashimoto's thyroiditis),as these patients may be at an increased risk for the neck central lymph node metastasis.