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Objective To investigate the related factors of central regional lymph node metastasis (CLNM) in patients with papillary thyroid microcarcinoma (PTMC).Methods The clinical and pathological fea tures of 550 cases of PTMC with clinical lymph node negative (cN0) were retrospectively analyzed.x2 test and multivariate logistic regression analysis were used to analyze the related factors of CLNM.ROC curve was used to analyze tumor diameter and CLNM of PTMC.Results The CLNM rate was 35.6％.Univariate analysis showed that patients aging less than 45 y(x2=13.983,P＜0.001),with tumor diameter≥7 mm (x2=14.263,P＜0.001),with capsule invasion (x2=7.316,P=0.006),multifocality (x2=14.321,P＜0.05) and bilateral tumors (x2=9.265,P=0.002) were more likely to have CLNM.Multivariate Logistic regression analysis showed that age ＜45 y,tumor diameter ≥7 mm,invasion of capsule and multifocal are all independent risk factors of CLNM for patients with PTMC.The optimal cutoff value of CLNM by diameter was 8 mm.Conclusion The CLNM of PTMC is related to many factors.When the age of the patient is less than 45 y,the diameter of the tumor is more than 7 mm,the invasion of the capsule and the multifocal lesion,the central lymph node dissection should be performed.
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Objective To explore the lateral neck lymph node metastasis (LNM) in patients affected by papillary thyroid carcinoma(PTC) with clinically negative neck (cN0-PTC) and to discuss the necessity of prophylactic lateral neck lymph node dissection.Methods Clinical data of 651 cN0-PTC patients who underwnt surgical procedure in Tumor Hospital of Zhengzhou University from Jan.2012 to May.2015 were retrospectively analyzed.Chi-square test was used for univariate analysis.Results Of the 651 cN0-PTC patients,62.9％ had LNM (51.3％ in central neck,41.0％ in lateral neck,and 11.7％ with "skip" metastasis).The lateral neck metastasis rate was 50.9％ in men and 37.7％ in women (P＜0.05),61.9％ in patients with tumor diameter ＞1.0 cm and 25.9％ in patients with tumor diameter ≤ 1.0 cm (P＜0.001),47.2％ with multifocal cancer and 40.3％ with unifocal tumor(P＜0.05),63.1％ with extrathyroidal extention and 34.3％ without extention (P＜0.001),64.1％ with ≥3 positive nodes in central neck and 48.3％ with ＜3 positive nodes (P＜0.05),52.4％ with upper lobe cancer and 32.9％ with other locations(P＜0.001),41.0％ in patients ≤45 years and 40.9％ in patients ＞45 years(P＞0.05).Conclusion Central neck dissection should be performed in all cN0-PTC patients.Prophylactic lateral neck dissection should beselectively performed in cN0-PTC patients with following high-risk factors:male,tumor diameter ＞1.0 cm,multifocal cancer,extrathyroidal extention,≥ 3 positive nodes in central neck and upper lobe cancer.
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After mice swam for one to three weeks, the splenic mononuclear cells (MNC)were measured by flow cytometry. The data showed that the trained mice MNCnumber decreased (trained group: 36.6? 16.6?10~6/spleen; control group: 62.4?21.6?10~6/spleen, P