Risk factors for central lymph node metastasis in papillary thyroid microcarcinoma:an analysis of 855 patients / 中国基层医药

ABSTRACT

Objective To investigate the clinical features of papillary thyroid microcarcinoma(PTMC) and the risk factors of central lymph node metastasis (CLNM) in PTMC patients.Methods The clinical data of 855 patients with PTMC who underwent prophylactic central lymph node dissection were retrospectively reviewed.Results In the present study,the rate of CLNM was 21.9％ (187/855) in PTMC patients.In the univariate analysis,the incidence of CLNM was significantly higher in male patients,age ＜ 45 years,tumor size ＞ 5 mm,capsular invasion,multiple tumor and intracapsular spread (31.4 ％ vs.19.5 ％,x2 =11.429,P =0.001;29.3 ％ vs.15.9 ％,x2 =22.416,P =0.000;30.0％ vs.14.3％,x2 =30.669,P=0.000;29.4％ vs.16.8％,x2 =19.233,P =0.000;30.0％ vs.19.9％,x2 =8.205,P =0.004;42.9％ vs.21.3 ％,x2 =5.549,P =0.018,respectively).Multivariate analysis showed that male gender,age ＜ 45 years,tumor size ＞ 5mm,multiplicity and capsular invasion were independent risk factors for CLNM in PTMC patients (95％ CI0.380-0.834,0.349-0.693,1.450-3.060,1.078-2.229,1.024-2.373,respectively).Conclusion A routine prophylactic central lymph node dissection should be considered particularly in male PTMC patients with age ＜45 years,tumor size ＞5 mm,capsular invasion and tumor multiplicity.