Clinical risk factors for central compartment lymph node metastasis in papillary thyroid cancer(cN0) / 中华普通外科杂志

ABSTRACT

Objective To analyze the risk factors of central compartment lymph node (CCLN)metastasis in papillary thyroid carcinoma(PTC) without clinically suspected cervical lymph node metastasis (cN0).Methods Clinical data of 272 PTC (cN0) patients who underwent radical thyroidectomy and CCLN dissection between January 2008 and December 2012 in Huashan hospital were retrospectively analyzed.Patients were divided into CCLN positive group (115 cases)and CCLN negative group(157 cases) according to postoperative pathology.Chi-square test,wilcoxon test and multivariate logistic regression analysis were used to analyze risk factors.Results CCLN metastasis of papillary micro thyroid cancer (PMTC) and papillary thyroid cancer (PTC) was 34.9％ and 48.3％,respectively.Tumor size (x2 =10.26,P ＜ 0.01),position(x2 =13.87,P ＜ 0.01),capsular invasion(x2 =20.19,P ＜ 0.01),multifocal PTC(x2 =7.42,P ＜ 0.01) and unmicro-carcinoma (x2 =5.12,P ＜ 0.05) were significantly correlated to lymph node metastasis.Middle area or lower pole of thyroid carcinoma,capsular invasion and multifocal PTC were independent risk factors of CCLN metastasis in PTC.Conclusions The cN0 PTC has a high rate of pathological CCLN metastasis,it is imperative to conduct thyroidectomy with ipsilateral level CCLN dissection in PTC patients.