A clinical study of lymph node metastasis rate,risk factors and dissection strategy in the central and lateral cervical region of stage cN0 papillary thyroid microcarcinoma
Objective To investigate the lymph node metastasis rate,risk factors and dissection strategy in the central and lateral cer-vical region of lymph node negative(cN0 stage)papillary thyroid microcarcinoma(PTMC).Methods 300 patients with stage cN0 PTMC who underwent surgical treatment were selected as the study objects.General data of all patients were collected and their clinicopathological data were retrospectively analyzed.The related factors that may affect cN0 stage PTMC lymph node metastasis were analyzed by method of univariate and multivariate Logistic regression analysis.Results Among 300 patients with cN0 stage PTMC undergoing surgical treatment,174 cases(58.00%)had no lymph node metastasis and 126 cases(42.00%)had lymph node metastasis.There were 118 cases(39.33%)of central lymph node metastasis,42 cases(14.00%)of lateral lymph node metastasis,34 cases(11.33%)of central with lateral lymph node metastasis,8 cases(2.67%)with lymph node metastasis in lateral cervical region but not central region,i.e.skipping lymph node metastasis.For male,age<45 years,tumor diameter≥0.5 cm,capsular in-vasion was independent risk factor for central lymph node metastasis of PTMC(P<0.05).For male,age<45 years,tumor diameter≥0.5 cm,upper pole tumor,capsular invasion and central lymph node metastasis were independent risk factors for lymph node metastasis in the lateral cervical region of PTMC(P<0.05).Conclusion For male,age<45 years old,tumor diameter≥0.5 cm,capsular invasion are all independent risk factors for central and lateral lymph node metastasis of PTMC.The independent risk factors for lateral lymph node metastasis also include upper pole tumor and central lymph node metastasis.In clinical practice,this can be used to determine the area of lymph node metastasis and adopt targeted dissection strategies to improve the prognosis in patients.
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