Analysis of risk factors for cervical lymph node metastases in patients with papillary thyroid microcarcinoma / 中国医师进修杂志

ABSTRACT

Objective To analyze the risk factors for cervical lymph node metastasis in patients with papillary thyroid microcarcinoma (PTMC). Methods The clinical data of 289 patients with PTMC from January 2013 to December 2014 were analyzed retrospectively. All patients underwent thyroidectomy and thyroid isthmectomy/total thyroidectomy plus central (and lateral) cervical lymph node dissection. Results In 289 patients, postoperative pathology confirmed that the central lymph node metastasis was in 118 cases (40.8% ); 64 of them performed central and lateral cervical lymph node dissection, and the rate of lateral cervical lymph node metastasis was 42.2% (27/64). The smooth curve fitting chart showed that the risk of central cervical lymph node metastasis was significantly increased when the tumor diameter ＞ 6 mm. Univariate analysis result showed that central cervical lymph node metastasis was associated with gender, number of primary lesions, unilateral and bilateral tumor, capsule invasion, tumor diameter and Hashimoto thyroiditis (P<0.05 or＜0.01); multivariate Logistic regression analysis result showed that the tumor diameter>6 mm was the independent risk factor for central cervical lymph node metastasis ( OR = 2.036, 95% CI 1.160 - 3.573, P = 0.013). Univariate analysis result showed that lateral cervical lymph node dissection was associated with central cervical lymph node dissection (P<0.05); multivariate Logistic regression analysis result showed that central cervical lymph node dissection was the independent risk factor for lateral cervical lymph node dissection in patients with PTMC ( OR=9.630, 95% CI 1.150-80.628, P=0.037). Conclusions PTMC patients with central or lateral cervical lymph node metastasis is very common, and central lymph node metastasis risk increases significantly when tumor diameter > 6 mm; the risk of lateral cervical lymph node metastasis also significantly increases in patients with central cervical lymph node metastasis.