Biomedical Research

Objective: To explore risk factors of cervical lymph node metastasis of PTMC.

Methods: Clinical pathological data of 169 PTMC patients in thyroid gland surgery in affiliated hospital of Guizhou medical university from January, 2014 to March, 2016 were given retrospective analysis.

Results: 169 cases were given preventive central compartment lymph node clean, of which, 54 cases (32%) had central compartment lymph metastasis. Multiple factors analysis showed that age (OR=1.512, 95% CI: 1.231-1.795, P<0.05), multifocal tumor (OR=2.912, 95% CI: 2.134-3.702, P<0.05), out of envelope (OR=3.818, 95% CI: 1.716-8.494, P<0.05) were independent factors of central compartment lymph metastasis. 30 cases were given central compartment lymph node and lymph node clean in lateral cervical area, of which, 18 cases had lymph node metastasis in lateral cervical area. Multiple factors analysis showed that tumor out of envelope (OR=3.72, 95% CI: 1.693-4.852, P<0.05) was high risk factor of lymph node metastasis in lateral cervical area. 11 cases (6.5%) had central compartment lymph node and lymph node metastasis in lateral cervical area. Out of envelope (OR=2.578, 95% CI: 2.072-3.211, P<0.05) and multifocal tumor (OR=3.229, 95% CI: 1.530-6.814, P<0.05) were high risk factors of central compartment lymph node and lymph node metastasis in lateral cervical area. The sensitivity and specificity of cervical lymph node B ultrasound with high resolution on central compartment lymph node metastasis were 14.8% and 96.5% respectively, lymph node metastasis in lateral cervical area were 94.4% and 83.3% respectively.

Conclusion: Age, multifocal tumor, extrathyroidal invasion are risk factors of PTMC cervical lymph node metastasis. High frequency neck ultrasound examination could be used as a preoperative assessment approach of PTMC lymph node metastases.

Author(s): Yufei Wang, Jie Han, Guochao Zhang, Yingying Hu
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