Analysis of clinicopathological characteristics and metastatic risk factors for patients with lymph node metastasis in central region of differentiated thyroid cancer / 肿瘤研究与临床

ABSTRACT

Objective:To investigate the clinicopathological characteristics and metastatic risk factors for patients with lymph node metastasis in central region of differentiated thyroid cancer, and to provide a basis for clinical treatment.Methods:A total of 200 patients with differentiated thyroid cancer from January 2017 to October 2018 in Jiangmen Central Hospital of Guangdong Province were selected. According to the central lymph node metastasis, the patients were divided into metastasis group and non-metastasis group. The clinicopathological features of the two groups were compared, including gender, age, tumor diameter, lesion gland lobe, the number of tumors, TNM staging, capsular infiltration, thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (TG-Ab), operation mode, blood flow grading, microcalcification, thyroid peroxidase antibody (TPO-Ab) and pathological type. The relationship between central lymph node metastasis and clinical characteristics was analyzed. The risk factors of central lymph node metastasis were analyzed by using logistic regression model.Results:Of the 200 patients, 52 (26.00%) patients had central region lymph node metastasis and 148 (74.00%) patients had no central region lymph node metastasis. The tumor diameter ≥ 2 cm, capsule infiltration, microcalcification and grade Ⅲ blood flow in the metastasis group were all higher than those in the non-metastasis group, and the differences were statistically significant [86.5% (45/52) vs. 68.2% (101/148), 40.4% (21/52) vs. 16.9% (25/148), 34.6% (18/52) vs. 11.5% (17/148), 23.1% (12/52) vs. 7.4% (11/148), all P < 0.05]. There were no statistically differences in the proportion of patients stratified by other clinicopathological factors (all P > 0.05). Logistic regression model suggested that tumor diameter ≥ 2 cm ( OR = 1.424, 95% CI 1.041-1.948, P = 0.009), capsular infiltration ( OR = 3.541, 95% CI 1.378-9.099, P = 0.009), microcalcification ( OR = 4.058, 95% CI 1.693-9.727, P = 0.002) and grade Ⅲ of blood flow ( OR = 5.174, 95% CI 2.148-12.463, P < 0.01) were independent risk factors for lymph node metastasis in central region. Conclusion:Central lymph node metastasis in patients with differentiated thyroid cancer is related to tumor diameter, capsular infiltration, microcalcification and grade Ⅲ of blood flow, which should be paid more attention in clinic.