Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (2): 57-64.doi: 10.6040/j.issn.1671-7554.0.2022.1004

• 临床医学 • Previous Articles     Next Articles

Patterns and risk factors of cervical lymph node metastasis in 934 cases of papillary thyroid microcarcinoma

SHAO Changxiu1,2, HE Qingqing2, ZHUANG Xiaoxuan3, LI Xiaolei2, ZHOU Peng2, YUE Tao2, GAO Yuan2,4, XU Jing2, LI Chenyu1,2, GUO Haonan1,2, ZHUANG Dayong2   

  1. 1. Postgraduate Training Base of the 960th Hospital of PLA Joint Logistics Support Force of Jinzhou Medical University, Jinan 250031, Shandong, China;
    2. Department of Thyroid and Breast Surgery, The 960th Hospital of PLA Joint Logistics Support Force, Jinan 250031, Shandong, China;
    3. International Medical College of Chongqing Medical University, Chongqing 400016, China;
    4. The 963th Hospital of PLA Joint Logistics Support Force, Jiamusi 154002, Heilongjiang, China
  • Published:2023-02-17

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Abstract: Objective To explore the patterns and risk factors of cervical lymph nodes metastasis(LNM)of papillary thyroid microcarcinoma(PTMC), in order to provide clinical evidences for reasonable and standardized surgical procedures. Methods Pathological data of 934 PTMC patients who underwent lateral lymph node dissection during Jan. 2019 and Dec. 2021 were retrospectively analyzed. The cervical LNM data were collected. The relationship between cervical LNM and different clinical characteristics and risk factors of LNM were analyzed. Results Among the 934 patients, the rate of central and/or lateral LNM was 50.64%(473/934); the rates of central and lateral LNM were 47.86%(447/934)and 20.77%(194/934), respectively. Among the 447 patients with central LNM, 168(37.58%)also had lateral LNM. The rate of lateral LNM without central LNM was 2.78%(26/934). Chi-square analysis showed that male, tumor diameter larger than 0.55 cm, extracapsular invasion, bilateral cancer, and multifocality were related to higher rate of cervical LNM, central LNM and lateral LNM(P<0.05); patients without Hashimotos thyroiditis had higher rate of cervical LNM and central LNM(P<0.05); patients of specific pathological types had higher rate of cervical LNM and lateral LNM(P<0.05). The binary multivariate Logistic regression analysis showed that male, tumor diameter larger than 0.55 cm, bilateral cancer, and without Hashimotos thyroiditis were independent risk factors of cervical LNM and central LNM; tumor diameter larger than 0.55 cm, extracapsular invasion, and specific pathological subtypes were independent risk factors of lateral LNM. For PTMC patients with single foci, the rate of lateral LNM was higher when the tumor was located in the upper pole of glands and isthmus than in the middle and lower. Conclusion PTMC patients with high probability of central LNM should receive regular central lymph node dissection. For patients with tumor diameter larger than 0.55cm, extracapsular invasion, specific pathological subtypes, and tumor located in the upper pole or isthmus, there is an increased risk of lateral LNM, and lateral lymph node dissection can be considered.

Key words: Papillary thyroid microcarcinoma, Cervical lymph node metastasis, Metastasis rate, Risk factors

CLC Number: 

  • R736.1
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