| Objective: Based on the clinical characteristics of patients with papillary thyroid microcarcinoma,the risk factors of lateral cervical lymph node metastasis of PTMC were explored to provide more theoretical basis for the treatment of lateral cervical lymph node metastasis of PTMC.Methods:The clinical data of 180 patients with papillary thyroid microcarcinoma from January 2017 to January 2018 in the fourth,hebei medical university hospital were collected.Of these patients,32 cases had neck lymph node metastasis.The clinical pathological characteristics were retrospectively analyzed,including age,gender,lesion location,size,number,whether with Hashimoto’s thyroiditis and lymph node metastasis in central region.All date were analyzed with SPSS24.0 statistical software.X~2 test was used for the comparison of univariate classification data.Univariate analysis of statistically significant variables was incorporated into logistic regression analysis of multivariate classification to determine independent risk factors.P < 0.05 was considered statistically significant.The relationship between clinical features and lateral cervical lymph node metastasis was studied,providing more reliable basis for the diagnosis of the disease.Results:1.The univariate analysis showed that the metastatic rates of lateral cervical lymph node metastasis in male and female were 15.6% and 18.5% respectively(X~2 = 0.203 P = 0.653);The metastatic rates of lateral cervical lymph node metastasis in patients ≤ 45 years old and > 45 years old were 19.2% and 16.0% respectively(X~2 = 0.301 P = 0.583);The metastatic rates of lateral cervical lymph node metastasis with tumor length ≤0.5cm and 0.5cm<D≤1.0cm were 11.4% and 22.8% respectively(X~2 = 3.927 P< 0.05).The metastatic rates of lateral cervical lymph node metastasis in the upper pole,middle pole and lower pole were 28.9%,14.9% and 13.1% respectively(X~2 = 5.138 P = 0.07);The metastatic rates of lateral cervical lymph node metastasis in single and multiple foci were 13.7% and 26.8% respectively(X~2 = 4.513 P< 0.05).The metastatic rates of lateral cervical lymph node metastasis with and without HT were 15.4% and 19.1%(X~2= 0.399 P= 0.528).The lateral cervical lymph node metastasis rate was 24.8% when the central lymph node metastasis was positive and 4.8% when the central lymph node metastasis was negative(X~2 = 11.233 P < 0.05).2.The multivariate regression analysis showed that tumor diameter was an independent risk factor for lymph node metastasis in the cervical region(OR= 2.472,95%CI1.020~5.989,P= 0.045).Multifocal lymph node metastasis is an independent risk factor for cervical lymph node metastasis(OR= 3.588,95%CI1.557~8.268,P= 0.003).Lymph node metastasis in the central region was an independent risk factor for lymph node metastasis in the cervical region(OR= 5.968,95%c CI1.705~20.890,P = 0.005).3.The lateral cervical lymph node Ⅱ,Ⅲ,Ⅳ,Ⅴ metastasis rate was 31.25%,56.25%,62.5%,9.4% respectively.Conclusion: For papillary thyroid microcarcinoma,univariate analysis showed that gender,age,tumor location and associated HT were not factors affecting lateral cervical lymph node metastasis;tumor long diameter >0.5cm,multifocal and central lymph node metastasis positive neck Factors affecting lateral lymph node metastasis.At the same time,multiple regression analysis showed that tumor long diameter >0.5cm,multifocal and lateral cervical lymph node metastasis were independent risk factors for cervical lymph node metastasis.The Ⅳ area of the lateral cervical lymph node metastasisof PTMC is the most common,followed by the Ⅲ area,and the Ⅴ area is the least. |
