Risk factors of the central lymph node metastasis in papillary thyroid carcinoma / 中华地方病学杂志

ABSTRACT

Objective To study the risk factors of central lymph node (CLN) metastasis in papillary thyroid carcinoma (PTC),to provide the basis for clinical treatment.Methods A total of 407 patients with PTC in thyroid surgery,the Third Affiliated Hospital of Harbin Medical University from January 2010 to June 2012 who had undergone at least ipsilateral CLN were studied.These factors included normal situation,thyroidglobulin antibody or thyroid microsomal antibody,family history,pathological features (the size of primary,tumor multifocal,tumor location and capsular invasion),TNM staging and CLN metastasis.Univariate analysis and multivariate analysis were performed using x2 test and binary Logistic regression test,respectively.Results The CLN metastasis rate was 51.351％ (209/407) of the 407 patients with PTC.The CLN metastasis was significantly associated with age,tumor multifocal,the size of primary tumor,capsular invasion and TNM (x2 =21.080,14.974,47.671,12.858,8.765,all P ＜ 0.01).Sex,thyroid globulin antibody or thyroid microsomal antibody,family history and tumor location were not associated with CLN metastasis (x2 =1.457,1.106,0.000,0.260,all P ＞ 0.05).Multivariate analysis indicated that age (＜ 45 year),the size of primary tumor (≥ 1.0 cm),tumor-muhifocal,and TNM (T3 + T4) were the independent risk factors for CLN metastasis [odds ratio (OR) =0.937,2.347,0.380,0.389,all P ＜ 0.01].Conclusions Age (＜ 45 year),the size of primary tumor (≥ 1.0 cm),tumor-multifocal and TNM (T3 + T4) are risk factors for CLN metastasis in PTC.Dissection of CLN should be considered for PTC patients with these factors.