Analysis Of Characteristics For Cervical Lymph Node Skip Metastasis In Papillary Thyroid Carcinoma

Objective:To investigate the actual incidence of cervical lymph node skip metastasis of thyroid papillary carcinoma,analyze the risk factors and build the prediction model for its occurrence.Methods:A case-control study was used to collect patients diagnosed with papillary thyroid cancer in Zhuhai People’s Hospital from January 2018 to December 2021,who received bilateral total thyroidectomy,curative or preventive bilateral central group lymph node dissection,and at least ipsilateral lateral lymph node dissection.These cases were divided into skip group and non-skip group according to the occurrence of skip metastasis for counting the actual incidence.Univariate analysis and logistic regression were performed to uncover the risk factors for skip metastases.The ROC curve was used to establish the prediction model.Results:The incidence of cervical lymph node skip metastasis of PTC was 9.28%.Univariate analysis showed that the occurrence of skip metastasis of PTC cervical lymph node was related to tumor diameter<1cm)and llocated in the upper pole)(P values were 0.018 and 0.042,both less than 0.05).Binary logistics regression analysis showed that tumor diameter was an independent risk factor for the occurrence of skip metastasis in PTC,and the OR value was 6.966(1.537,31.575).ROC curve results indicated that tumor diameter<1cm had only negative value for PTC cervical lymph node skip metastasis(AUC:0.678;Sensitivity:0.740;Specificity:0.615).Conclusion:in this study,a total of 140 cases met the inclusion criteria,including 13 cases with skip metastasis,The incidence of cervical lymph node skip metastasis of PTC was 9.28%.and tumor location in the upper pole and tumor diameter<1cm were risk factors for cervical lymph node skip metastasis of PTC.Diameter can be used as a negative predictor of the occurrence of PTC cervical lymph node skip metastasis.It means when PTC diameter>1cm,skip metastasis is not likely to occur.