OBJECTIVE The objective of this study is to discuss when to dissect the
lymph nodes behind the right
recurrent laryngeal nerve (LN-prRLN) from the standpoint of the right cervical level Ⅵ-1 (superficial layer to the
recurrent laryngeal nerve )
lymph nodes in
papillary thyroid carcinoma (PTC)
patients .
METHODS The clinical data of 306 bilateral or right PTC
patients from the Hangzhou First People's
Hospital who underwent
dissection of level Ⅵ-1
lymph nodes and LN-prRLN between March 2014 and September 2015 were analyzed. We measured the number of level Ⅵ-1 metastatic
lymph nodes and size of level Ⅵ-1
lymph nodes metastasis loci to predict the
metastasis of LN-prRLN.RESULTS The number of level Ⅵ-1 metastatic
lymph nodes and size of level Ⅵ-1
lymph nodes metastasis loci were
risk factors of LN-prRLN
metastasis (P<0.05). When the number of the level Ⅵ-1 metastatic
lymph nodes was greater than 1.5, the
AUC was 0.813 (the
sensitivity was 78.43%, the
specificity was 76.65%). The ROC showed that when the size of level Ⅵ-1
lymph nodes metastasis loci were more than 0.45 cm, the
AUC was 0.726 (
sensitivity was 90.20%,
specificity was 48.90%).CONCLUSION In bilateral or right PTC
patients with
metastasis of level Ⅵ-1
lymph nodes , especially when the number of level Ⅵ-1 metastatic
lymph nodes was greater than 2cm and the
metastasis loci were more than 0.45 cm, we should dissect the LN-prRLN.