Analysis Of Related Factors Of Lymph Node Metastasis In Central Area Of Thyroid Micropapillary Carcinoma

Objective:To retrospectively analyze the clinicopathological data of lymph node metastasis of papillary thyroid microcarcinoma(PTMC),and to explore the risk factors of central lymph node metastasis(CLNM)in PTMC.Methods:From January 2017 to January 2019,a total thyroidectomy(unilateral gland lobe + isthmus or bilateral gland lobe)+ central node lymphadenectomy was performed in the vascular and thyroid surgery in the first affiliated hospital of Xinjiang Medical University from the same surgical treatment group.There were 527 patients with central lymph node dissection(CLND)(unilateral or bilateral)who were finally diagnosed by pathology as PTMC.All the patients were divided into case group and control group based on the presence and absence of central node lymph node metastasis.The related factors of lymph node metastasis in central region of PTMC were analyzed.Results:CLNM occurred in 168 of527 PTMC patients,and the metastasis rate was 31.88%.Analysis showed that males,PTMC patients with age <45 years,lesions with microcalcification,maximum lesion diameter ?5 mm,extraglandular invasion,CLNM rate was higher than women,age ?45years,maximum lesions diameter <5mm,lesions without microcalcification,without extraglandular invasion(P <0.05).The analysis showed that preoperative TSH,Tg-Ab,TPO-Ab,preoperative high suspicious malignant nodule blood flow signal,morphology,border,and nature,preoperative ultrasound TI-RADS classification,number of lesions,PTMC case group and control group with Hashimoto's thyroiditis.The differences were not statistically significant(P> 0.05).Multivariate Logistic regression analysis showed that males,age <45 years,lesions with microcalcification,lesions with a maximum diameter of 5 mm or more,and extraglandular invasion were independent risk factors for lymph node metastasis in the central area of PTMC.Conclusions:Central lymphadenectomy is recommended for PTMC patients who are male,younger than 45 years old,and have lesions with microcalcification,the largest diameter of which is?5mm,and extraglandular invasion.