Risk Factors For Lymph Node Metastasis In The Contralateral Central Region Of Unilateral Papillary Thyroid Carcinoma

Objective:The study analyzed the risk factors related to the contralateral central lymph nodes(Cont-CLNs)metastasis of unilateral papillary thyroid carcinoma(uPTC),and discussed the necessity of operating preventive Cont-CLNs dissection on uPTC patients,so as to provide references for clinicians to make clinical decisions.Methods:The clinical data were collected from 133 uPTC patients who had underwent total thyroidectomy and bilateral central lymphadenectomy at the general surgery department of the first hospital of Shanxi Medical University from January 2018 to December 2019,and were analyzed retrospectively.The patients were separated into different groups according to whether they had Cont-CLNs metastasis or not.The age,gender,tumor size,tumor number,tumor capsule invasion,extraglandular invasion,ipsilateral central lymph nodes(ipsi-CLNS)metastasis,lateral neck node metastasis(LLNM)and other risk factors were analyzed.SPSS 22.0 software was used to analyze the data by univariate and multivariate logistic regression analysis(P < 0.05).Results:Among 133 patients with uPTC who underwent total thyroidectomy and bilateral central lymph node dissection in general surgery department of our hospital,70 of them with positive Ipsi-CLNs metastasis accounted for 52.63%,30 patients with positive Cont-CLNs metastasis accounted for 22.56%,41 patients with Ipsi-CLNs positive and Cont-CLNs negative accounted for 30.83%,only 1 patient with Ipsi-CLNs negative and Cont-CLNs positive accounted for 0.75%,Ipsi-CLNs and Cont-CLNs were both positive in 29 cases of 21.80 %,and 62 patients with negative Ipsi-CLNs and Cont-CLNs constituted 46.62%.The results of single-factor chi-square test analysis showed that tumors with a diameter greater than 10 mm,tumors invading capsules,tumors invading surrounding tissues and organs,Ipsi-CLNs metastasis,and LLNM were significantly correlated with Cont-CLNs metastasis in uPTC patients(p <0.05).However,other related risk factors: age,gender,tumor number,combined with Hashimoto's thyroiditis(HT)and Cont-CLNs metastasis had no significant correlation(p> 0.05).Multivariate logistic regression analysis showed that tumor invasion of the capsule,Ipsi-CLNs metastasis,and LLNM were independent risk factors for Cont-CLNs metastasis in uPTC patients.Conclusion:Tumor invasion of the capsule,Ipsi-CLNs metastasis,and LLNM are independent risk factors for Cont-CLNs metastasis in uPTC patients.When uPTC patients are combined with the above high-risk factors,the possibility of Cont-CLNs metastasis is significantly increased,and full precautions of Cont-CLNs dissection should be considered.