Risk Factors Of Cervical Lymph Node Metastasis In Papillary Thyroid Carcinoma

ObjectiveTo explore the risk factors of cervical lymph node metastasis of papillary thyroid cancer by retrospectively analyzing the clinical data of patients with papillary thyroid cancer,and to provide reference for the formulation of surgical plan.MethodsClinical case data of patients with papillary thyroid carcinoma who underwent surgical treatment in the general surgery department of Zhangzhou hospital from January 2018 to December 2019 and were pathologically confirmed to be papillary thyroid cancer after surgery were selected.Retrospective analysis was conducted to investigate the relationship between age,gender,unilateral and bilateral tumor foci,tumor maximum diameter,multifocal,membranous invasion,extragglandular invasion,central lymph node metastasis,Hashimoto’s thyroiditis and nodular goiter,BRAF gene mutation and lymph node metastasis in cervical region of papillary thyroid carcinoma.SPSS 25 software was used for univariate analysis and multivariate regression analysis.Chi-square test and t test were used to compare the pathological characteristics of the two groups.Multivariate logistic regression was used to analyze the risk factors of cervical lymph node metastasis in papillary thyroid carcinoma.After surgery,we follow up patients for 1 year.ResultsA total of 474 patients met the inclusion criteria,including 123 patients with lateral cervical metastasis.In this study,univariate analysis showed that there was no correlation between cervical lymph node metastasis and nodular goiter in patients with papillary thyroid carcinoma(P=0.184).(P = 0.030),sex and age(P =0.027),cancer,single and double side(P = 0.013),tumor size(P = 0.005),the largest diameter multifocal invasion(P < 0.001),capsule(P < 0.001),glandular outside infiltration(P < 0.001),lymph node metastasis(P < 0.001)in the center,whether merger hashimoto thyroiditis(P < 0.001),mutated BRAF gene mutation(P= 0.038),and thyroid papillary carcinoma in patients with cervical lymph node metastasis related side area.Multiariable logistic regression analysis,according to the results of cancer single and double side(OR 1.804,P = 0.046),multifocal(OR3.052,P < 0.001),invaded by membrane(OR 2.072,P = 0.010),glandular outside infiltration(OR 3.820,P = 0.001),lymph node metastasis in the center(OR 5.807,P < 0.001),merging,hashimoto(OR 3.416,P < 0.001)side of the neck area is thyroid papillary carcinoma patients independent risk factors for lymph node metastasis.During the follow-up period,there were no cases of permanent hypoparathyroidism or recurrent laryngeal nerve injury,and 3 patients developed cervical lymph node metastasis and recurrence within 1 year after the operation,then received reoperation treatment and iodine-131 isotope radiotherapy,and there were no deaths.ConclusionAge,sex,unilateral and bilateral tumor foci,maximum size of tumor,multifocal,membranous invasion,extragglandular invasion,positive central lymph node metastasis,combined with Hashimoto’s thyroiditis,and BRAF gene mutation were associated with cervical lateral lymph node metastasis in patients with papillary thyroid carcinoma.With double side lobes are cancer,unilateral cancer number greater than or equal to 2,infringement,cancer infiltration gland cancer capsule fat,muscle and other groups,merge the central lymph node metastasis or merging hashimoto thyroiditis patients with thyroid papillary carcinoma,the side of the neck area is more likely to lymph node metastasis,should be more careful evaluation,in intraoperative take positive solution and bring a more optimal solution to the patients.