Clinical Risk Factors For The Contralateral Central Lymph Node Metastasis In CN0 Unilateral Papillary Thyroid Carcinoma:A Meta-analysis

Objective: To investigate the clinical risk factors of contralateral central lymph node metastasis in patients with c N0 unilateral thyroid papillary carcinoma(PTC)and to provide evidence for predicting and dissecting contralateral central lymph nodes.Methods: Relevant literature on the clinical risk factors for contralateral central lymph node metastasis of c N0 unilateral PTC was searched by computer in Pub Med,Embase.com,Cochrane Library,and Web of science databases.Meanwhile,relevant manuals were searched and referenced for reference.The deadline for the literature is December 2017,and the language limit is English.The quality of the included documents was evaluated,the relevant data was extracted using a unified table,and the Rev Man 5.3 software was introduced into the meta-analysis.Among them,the binary variables are represented by odds ratios(ORs)and their 95% CIs.Q and I2 were used to test the heterogeneity among the studies,and Rev Man 5.3 software was used to make a funnel plot to evaluate publication bias of each included literature.Results: A total of 703 relevant articles were retrieved.After screening,14 English articles were finally included in the meta-analysis.A total of 3003 unilateral PTC patients were included in the c N0,of whom 342 were patients with contralateral central lymph node metastases.Meta analysis results suggest that the combined effect of OR and 95% CI was 1.69 [1.26,2.27] for men,age ? 45 years,tumor maximal diameter > 2 cm,central lymph node metastasis,lymphatic vessel invasion,and extrageneral invasion.0.51 [0.39,0.66],3.28 [1.73,6.22],8.53 [4.86,14.97],4.18 [2.38,7.34],1.67 [1.27,2.20],the difference was statistically significant by Z test(P values were <0.00001,respectively),0.0005,0.0003,<0.00001,<0.00001,0.0002): Men,age ? 45 years,maximum tumor size >2cm,central lymph node metastasis in the affected area,lymphatic vessel invasion,extraglandular invasion,and c N0 unilateral PTC There was a significant correlation between lymph node metastasis in the central region and the combined OR and 95% CI of Hashimoto's thyroiditis(HT)were 1.05 [0.69,1.59],1.20[ 0.85,1.68],0.93 [0.38,2.27],there was no significant difference by Z test(all P>0.05),but the number of tumors,tumor capsule involvement,merger of Hashimoto's thyroiditis and c N0 alone could not be considered.Side PTC patients were involved in metastasis of the contralateral central lymph node.Conclusion: The results of this study show that: men,age ? 45 years,maximum tumor size >2cm,central lymph node metastasis in the affected area,lymphatic vessel invasion,and extra-invasional invasion are the clinical effects on the contralateral central lymph node metastasis in c N0 unilateral PTC patients.Risk factors.When the patient has the above risk factors,it suggests that the contralateral central lymph node metastasis is more likely to occur,and the contralateral central lymph node must be actively treated to reduce the residual tumor,recurrence and metastasis,and prolong the survival time of the patient.