| Objective:To investigate Delphian lymph node metastasis related to which clinicopathologic factors in papillary thyroid carcinoma.To investigate the significance of DLN metastasis in evaluating and treating papillary thyroid carcinoma by correlation analysis between DLN metastasis and clinicopathologic factors.Methods:In this paper,we reviewed the data of 648 thyroid cancer patients with rapid intraoperative pathology of DLN in the First Betnune Hospital of Jilin University from November 2014 to May 2018,648 patients were divided into DLN transfer group and DLN non-transfer group.The clinicopathological factors of the two groups were analyzed,including age,gender,maximum tumor diameter,tumor multifocality,tumor location,whether the tumer was bilateral,whether the tumor capsule invaded,whether the tumor contained central lymph node metastasis,whether the tumor contained lateral cervical lymph node metastasis.The clinicopathological factors of these two groups of patients were tested by x~2 using SPSS 22.0statistical software,the confidence interval was taken as 95%confidence interval.SPSS 22.0statistical software was then used to perform multiple logistic regression analysis for significant clinicopathological factors.Then DLN metastasis patients were divided into groups according to the number of DLN metastasis,and the number of DLN metastasis and lateral cervical lymph node metastasis were tested by x2 test using SPSS 22.0 statistical software,and the confidence interval was taken as 95%confidence interval.Results:Of the 648 patients with DLN,185 patients experienced DLN metastasis,for a DLN metastasis rate of 28.5%.Among them,a total of 337 patients(52.0%)were aged 45 years and older,and a total of 311 patients(48.0%)were aged less than 45 years,123(19.0%)male patients and 525(81.0%)female patients,140 patients(21.6%)had tumors larger than 1 cm in diameter and 508 patients(78.4%)had tumors 1 cm or less in diameter,there were 295patients(45.5%)with single tumor and 353 patients(54.5%)with multiple tumors.222patients with tumors located in the upper third of the lateral thyroid lobe and in the thyroid angina(34.3%),and tumor location was located in the middle and lower parts of the lateral lobe in 426 patients(65.7%),277 patients(42.7%)had bilateral tumor and 371 patients(57.3%)had unilateral tumor.There were 516 patients(79.6%)with capsule invasion and132 patients(20.4%)without capsule invasion,and 281 patients(43.4%)with central lymph node metastasis and 367 patients(56.6%)without central lymph node metastasis,86 patients(13.3%)with lateral cervical lymph node metastasis and 562 patients(86.7%)without lateral cervical lymph node metastasis.The x~2 test values and P values were derived as,age(x~2 value:1.169,P=0.160),and gender male(x~2 value:23.560,P<0.001),tumor diameter>1 cm(x~2value:61.250,P<0.001),multifocal tumors(x~2 value:9.046,P=0.002),The location of the tumor was located in the superior third of the thyroid angina and lateral thyroid lobe(x~2 value:119.399,P<0.001),the tumor was bilateral carcinoma(x~2 value:8.846,P=0.002),capsule invasion(x~2 value:24.001,P<0.001),central lymph node metastasis(x2 value:211.063,P<0.001),lateral cervical lymph node metastasis(x2 value:112.911,P<0.001).Multiple logistic regression analysis was performed to obtain that the tumor location was located in the upper third of the thyroid angina and lateral lobe(95%CI 0.079~0.220,OR=0.132,P value<0.001),tumor diameter>1 cm(95%CI 1.399~4.289,OR=2.450,P value=0.002);central lymph node metastasis(95%CI 8.747~27.152,OR=15.411,P value<0.001);lateral cervical lymph node metastasis(95%CI 2.420~9.835,OR=4.878,P value<0.001).Of the 185patients with DLN metastasis,66 patients had lateral cervical lymph node metastasis,including 81 patients with?2 DLN metastases,185 cases of DLN metastasis were divided into two groups according to whether the number of DLN metastasis was?2,and x~2 test was performed with the group of lateral cervical lymph node metastasis,the x~2 test value and P value were obtained,respectively,and the number of DLN metastases was?2(x~2 value:2.492,P=0.077).And then 185 cases of DLN metastasis were divided into two groups according to whether the number of DLN metastasis was?3,of which 28 cases had DLN metastasis?3.x~2 test was performed with lateral cervical lymph node metastasis group,and x~2 test value and P value were obtained.The number of DLN metastasis was?3(x~2 value:6.626,P=0.010).Conclusion:(1)DLN metastasis is related to gender,male,maximum diameter of tumor(>1cm),multifocal tumor,tumor location(located at the isthmus and the upper 1/3 of the lateral lobe),bilateral tumor,membranous invasion,six-region lymph node metastasis,and lateral cervical lymph node metastasis.(2)The location of the tumor at the isthmus and the upper 1/3 of the lateral lobe,the diameter of the tumor>1cm,the presence of six-region lymph node metastasis and lateral cervical lymph node metastasis were independent risk factors for DLN metastasis.(3)In patients with DLN metastasis,lateral cervical lymph node metastasis was more likely when the number of DLN metastases was?3. |
PDF Full Text Request