Analysis of risk factors for cervical lymph node metastasis in papillary thyroid carcinoma

doi:10.16139/j.1007-9610.2022.01.017

Abstract

Abstract:

Objective To study the clinical characteristics of cervical lymph node metastasis in patients with papillary thyroid carcinoma (PTC) and to explore the risk factors of nodal metastasis. Methods A retrospective analysis of the clinical data of 203 patients with PTC was conducted from January 2019 to December 2020 in Shanghai International Medical Center. The factors influencing cervical lymph node metastasis were analyzed by univariate analysis and multivariate Logistic regression. Results Rate of lymph node metastasis in 203 patients was 44.3% (90 cases) and 4.9% (10 cases) in la-teral compartment. Univariate analysis showed that rate of cervical lymph node metastasis was higher in males, thyroid calcification on ultrasonography, larger tumor, multifocus, tumor close to capsule, and the cases with overweight (P<0.05). Multivariate analysis showed that male, age younger than 45 years, larger tumor, multifocus, and tumor close to the capsule were independent risk factors of cervical lymph node metastasis. Tumor was more located in the upper thyroid pole for the patients with lateral lymph node metastasis. Conclusions Male, age younger than 45 years, larger tumor, multifocus, and tumor close to capsule would be risk factors for cervical lymph node metastasis in PTC. It is recommended to pay more attention to both preoperative evaluation and intraoperative exploration for cervical lymph nodes.

Key words: Papillary thyroid carcinoma, Cervical lymph node metastasis, Calcification

CLC Number:

R736.1

LIU Rongyao, LI Xiangcui, WANG Lina, CHEN Haizhen. Analysis of risk factors for cervical lymph node metastasis in papillary thyroid carcinoma[J]. Journal of Surgery Concepts & Practice, 2022, 27(01): 76-79.

Figures/Tables 2

References 22

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项目	总例数	转移例数	发生率（%）	χ²值	P值	标化残差^a)
性别
男	53	33	62.3	9.343	0.002^b)
女	150	57	38.0
年龄（岁）
<45	149	72	48.3	3.608	0.057
≥45	54	18	33.3
钙化
是	149	76	51.0	10.103	0.001^b)
否	54	14	25.9
病灶数
单发	150	58	38.7	7.480	0.006^b)
多发	53	32	60.4
肿瘤直径（cm）
0.1~0.4	52	10	19.2	26.1	<0.001^b)	-4.2
0.5~0.9	104	47	45.2			0.3
≥1.0	47	33	70.2			4.1
合并结节性甲状腺肿
是	35	11	31.4	2.855	0.091
否	168	79	47.0
合并桥本甲状腺炎
是	74	31	41.9	0.282	0.596
否	129	59	45.7
体质量指数（kg/m²）
18.5~23.9	111	42	37.8	6.597	0.037^b)	-2.0
>23.9	75	42	56.0			2.6
<18.5	17	6	35.3			-0.8
肿瘤距包膜（mm）
≤1	87	52	59.8	14.698	<0.001^b)
>1	116	38	32.8
肿瘤位置
上极	41	12	29.3	5.591	0.348
中极	56	26	46.4
下极	35	17	48.6
中上极	12	7	58.3
中下极	21	9	42.9
弥散	38	19	50.0

影响因素		OR	95%CI	P值
性别	男	2.797	1.246~6.275	0.013^a)
年龄（岁）	<45	3.726	1.639~8.473	0.002^a)
钙化	有	2.119	0.950~4.725	0.067
肿瘤直径（cm）	0.1~0.4			0.001^a)
	0.5~0.9	3.264	1.374~7.751	0.007^a)
	≥1.0	7.358	2.617~20.689	<0.001^a)
病灶数	多发	2.375	1.119~5.040	0.024^a)
肿瘤距包膜（mm）	≤1	3.399	1.689~6.840	0.001^a)
体质量指数（kg/m²）	18.5~23.9			0.181
	>23.9	1.707	0.791~3.686	0.173
	<18.5	0.544	0.164~1.810	0.321