Objective To investigate the association between serum levels of thyroglobulin(Tg),thyroid stimulating hormone(TSH)and antibodies and lymph node metastasis(LNM)in papillary thyroid cancer(PTC).Methods A total of 1 502 patients with PTC who were admitted to the Department of Breast and Thyroid Surgery of the First Affiliated Hospital of Chongqing Medical University from Jan.2019 to Jan.2022 were retrospectively enrolled,including males(n=431),females(n=1 071),aged＜55 years(n=1 271),and ≥ 55 years old(n=231).All patients were pathologically confirmed to have PTC after surgery.Univariate analysis was performed on the gen-eral data of patients and the indexes in the postoperative pathology report and the LNM group,and the data of P＜0.05 in the analysis were included in the regression analysis to determine the independent risk factors of cervical LNM in PTC patients.Patients were divided into 8 subgroups according to the different statuses of the three thyroid antibodies(TGAb,TPOAb,TRAb):[(+)indicates positive;(-)indicates negative].According to the order of TGAb,TPOAb,and TRAb,there are the following 8 states,1(+++);2(---);3(++-);4(+--);5(+-+);6(-±-);7(-++);8(--+)o The differences in general clinical information,Tg and TSH between the two groups were com-pared,and the receiver operating characteristic curve(ROC)curve of Tg in the diagnosis of PTC lymph node me-tastasis was constructed,and regression analysis was used to explore the diagnostic value of serological indicators in the diagnosis of cervical LNM in PTC.Results In this study,compared with the non-metastasis group,there were 308 males(33.2％)and 225 patients(24.3％)with bilateral PTC in metastasis group.The mean serum Tg value was(25.5±2.1)ng/mL and the TSH level was significantly increased(P＜0.05),and the results of binary lo-gistic regression analysis showed that males(OR=1.57,P＜0.001),bilateral PTC(OR=1.448,P＜0.001),non-pap-illary carcinoma(＞10 mm)(OR=1.745,P＜0.001)and increased Tg level(OR=1.007,P=0.002)were indepen-dent risk factors for cervical lymph node metastasis in PTC patients,and the area under the ROC curve of Tg in the evaluation of cervical lymph node metastasis was 0.634[95％CI(0.636,0.691),P＜0.05],while the TSH status was 0.56-1.39(OR=0.375,P=0.013).1.40-2.29(OR=0.422,P=0.003);2.30-5.91(OR=0.466,P=0.004);≥5.91(OR=0.41,P=0.001)was not a risk factor.Conclusion Male sex,bilateral thyroid cancer,non-papillary carcinoma(＞10 mm),and preoperative serum Tg＞29.8 ng/mL are the influencing factors of LNM in PTC patients.
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