Risk Factors Of Central Lymph Node Metastasis In Papillary Thyroid Microcarcinoma With CN0 And The Correlation Between Clinicopathological Features And NLR

Objective:To explore the clinical features of PTMC patients with cN0 and the risk factors of CLNM in PTMC patients with cN0,and analysis the correlation between clincopathological features and preoperative NLR in PTMC patients with cN0.Methods:Retrospectively analyzed the clinical and pathological data of 120 PTMC patients with cN0 admitted to the Department of Oncology,the First Affiliated Hospital of Bengbu Medical University in January 2018 to December 2018,and analyzed the clinical characteristics of PTMC patients with cN0 and the risk factors of CLNM.The ROC curve was used to predict the effect of preoperative NLR on CLNM.According to the cut-off value,the preoperative NLR was divided into low NLR group and high NLR group and analysis the correlation between clincopathological features and preoperative NLR in PTMC patients with cN0.Results:In 120 PTMC patients with cN0,there are 51(42.5%)patients was occurred to CLNM.Univariate analysis showed CLNM was related to tumor size,capsule invasion,multifocalitiy,preoperative NLR and preoperative PLR(P<0.05),but not related to gender,age and primary tumor location(P> 0.05).Multivariate analysis found that tumor size(OR=3.608,95%CI=1.326～9.816,P = 0.012),multifocalitiy(OR=2.733,95%CI=1.021～7.318,P=0.045),capsule invasion(OR=3.217,95% CI=1.193～8.674,P=0.021)and preoperative NLR(OR=2.838,95%CI=1.080～7.458,P=0.034)are the risk factors for CLNM of PTMC patients with cN0.The AUC value of preoperative NLR in predicting CLNM was 0.845(95%CI=0.774～0.916),,and the cut-off value was 1.89.Univariate analysis showed preoperative NLR is related to tumor size and the number of CLNM(P<0.05),but not related to gender,age,primary tumor location,multifocality and capsule invasion(P>0.05).Spearman’s correlation coefficient for ranked data showed peroperative NLR was related to tumor size(r= 0.434,P <0.001).Conclusion:The CLNM of PTMC patients with cN0 is related to many factors.For patients with these high-risk factors,PCND should be performed.The cut-off value of preoperative NLR in predicting CLNM was 1.89.Preoperative NLR was correlated with tumor size and the number of CLNM in PTMC patients with cN0,and it was positively related to tumor size.