Risk Factors Of Central Lymph Node Metastasis In Papillary Thyroid Carcinoma

Objective: To investigate the risk factors of central lymph node metastasis in papillary thyroid carcinoma and the relationship between the site of capsule invasion and central lymph node metastasis.Method: The clinicopathological characteristics of 234 patients with PTC treated by thyroid surgery in the Second Hospital of Hebei Medical University from December 2018 to December 2019 were retrospectively analyzed.Binary Logistic regression was used to analyze the risk factors of central lymph node metastasis.Receiver operating characteristic(ROC)curves were drawn and AUC was used to calculate the discrimination of multivariate regression.Using Fisher's exact probability method,we analyzed the relationship between different parts of the PTC tumor with capsule invasion and central lymph node metastasis in 118 cases of PTC.Result: Among the 234 cases,123 cases(52.6%)were pathologically proved to have central lymph node metastasis,and 111 cases(47.4%)were pathologically proved to have no central lymph node metastasis.Univariate analysis showed that lymph node metastasis in the central region of neck was associated with age<55 years,tumor diameter>1cm,capsule invasion and BRAF-V600 E gene mutation(P < 0.05 or P < 0.01),but not with sex and tumor location(P > 0.05).Multivariate analysis showed that age<55 years,tumor diameter>1cm and capsule invasion were independent risk factors for central lymph node metastasis.Risk factors(Age,Tumor size,Capsule invasion)for central lymph node metastasis of PTC were evaluated with predictive model discrimination,and the results showed that the AUC was 0.748,and the predictive diagnostic ability was moderate.There were 118 cases of PTC with capsule invasion,including 42 cases of anterior capsule invasion,50 cases of posterior capsule invasion,7 cases of tracheal capsule invasion and 19 cases of others.The results showed that there was no statistical significance between the location of the tumor invading the capsule and the central lymph node metastasis(P > 0.05).Conclusion: For patients with PTC,the risk of central lymph node metastasis is increased with age <55 years,capsule invasion and tumor diameter>1cm,and central lymph node dissection is recommended.