Analysis Of The Clinical Pathological Characteristics Of 22 Cases Of Medullary Thyroid Carcinoma And The Related Factors Affecting Cervical Lymph Node Metastasis In Patients

Objectives:1.To explore the clinicopathological characteristics of 22 cases of medullary thyroid carcinoma(MTC)and analyze clinical pathology differences between SMTC and HMTC.2.To analyze the risk factors affecting cervical lymph node metastasis in MTC patients,and provide effective guidance and assistance for better assessment of the surgical methods of MTC.Methods:1.22 cases of MTC surgical resection specimens were collected,which were archived in the Department of Pathology,First Hospital of Shanxi Medical University from January2004 to December 2019.The clinical and pathological data of MTC patients were recorded in detail,and the retrospective analysis and immunohistochemical staining were performed to illustrate the clinicopathological characteristics and immunohistochemical phenotypes.2.By using the statistical SPSS 22.0 software,the clinical data between sporadic MTC and hereditary MTC were compared through Fisher's exact probability method,and the related factors affecting cervical lymph node metastasis in MTC patients were analyzed through Fisher's exact probability method and multi-factor Logistic regression analysis.Results:1.The comparison of clinical data between sporadic MTC and hereditary MTC: The number of lesions had significant differences between the sporadic MTC and hereditary MTC groups(P<0.05,statistically significant difference),while there were no significant differences for age,sex,maximum tumor diameter,cervical lymph node metastasis,Ki-67 proliferation index,the expression of calcitonin and SSTR2,and the Congo red-staining result between the sporadic MTC and hereditary MTC groups(P>0.05,no statisticallysignificant difference).2.The results of immunohistochemical staining: The positive rate of calcitonin staining was 91%(20/22),The positive rate of SSTR-2 staining was 55%(12/22),and Ki-67 with proliferation index ? 3%,was(64% 14/22).3.The results of single-factor Fisher exact probability method: the maximum tumor diameter(> 1 cm),the Ki-67 proliferation index(? 3%),and the positive-expression of SSTR2 had significant differences with the cervical lymph node metastasis in MTC patients(P < 0.05,statistically significant difference).while there were no significant differences for age,sex,and the number of lesions result with the cervical lymph node metastasis in MTC patients(P>0.05,no statistically significant difference).4.The results of multi-factor Logistic regression analysis: The Ki-67 proliferation index(?3%)was an independent factor affecting the cervical lymph node metastasis in MTC patients(P < 0.05,statistically significant difference).Conclusion:1.As compared to sporadic MTC,the multiple lesions are more common in hereditary MTC,while there were no significant differences for Ki-67 proliferation index,the expression of calcitonin and SSTR2 between the sporadic MTC and hereditary MTC groups2.The maximum tumor diameter(? 1 cm),the Ki-67 proliferation index(? 3%),and the positive-expression of SSTR2 are the related factors for cervical lymph node metastasis in MTC patients.3.The Ki-67 proliferation index(? 3%)is an independent factor for cervical lymph node metastasis in MTC patients.