Related risk factors of central lymph node metastasis in papillary thyroid microcarcinoma of cN0 stage / 中华内分泌外科杂志

ABSTRACT

Objective:To investigate the risk factors of lymph node metastasis in the cervical region VI (central region) in patients with papillary thyroid microcarcinoma (PTMC) of cN0 stage, and then to determine whether to perform prophylactic central lymph node dissection.Methods:The clinical data of 500 patients with PTMC who underwent surgery from Jan. 2013 to Dec. 2015 in Ningbo First Hospital were retrospectively analyzed. Due to the pathological results, all patients were divided into two groups: central lymph node metastasis (CLNM) positive group and CLNM negative group. SPSS18.0 was used for analyzing.Results:Of the 500 cases of PTMC of cN0 stage, 142 cases had lymph node metastasis. Gender, the maximum tumor diameter, tumor invasion outside the gland, boundary, calcification in tumor, single or multiple lesions, aspect ratio and blood flow were risk factors for CLNM in patients with PTMC of cN0 stage. Multivariate analysis identified that male ( P=0.014) , tumor size ≥0.5 cm ( P=0.03) , tumor invasion outside the gland ( P=0.003) , unclear boundary ( P=0.032) , calcification ( P=0.009) , aspect ratio ≥1 ( P=0.001) were independent predictors factors for CLNM of PTMC. Conclusion:Male, unclear boundary, tumor size ≥0.5cm, tumor invasion outside the gland, calcification, aspect ratio ≥1 are the risk factors of CLNM in patients with cN0 PTMC. Prophylactic central lymph node dissection should be performed for patients without lymph node metastasis but with one risk factor or more.