Analysis Of Risk Factors For Skip Lateral Cervical Lymph Node Metastasis In Papillary Thyroid Carcinoma

Objective: This study explored the risk factors of PTC skip metastasis through clinical retrospective analysis combined with Meta analysis,in order to provide a theoretical basis for clinical lymph node dissection.Methods: Part 1: The clinical data of 87 patients with PTC in our hospital were analyzed retrospectively.According to whether the patients had skip lymph node metastasis,they were divided into two groups(11 cases in the skip metastasis positive group and 76 in the skip metastasis negative group).example).Statistical analysis was performed using SPSS26 statistical software.Part 2: Literatures on risk factors for cervical lymph node skip metastasis of papillary thyroid carcinoma published in the past 10 years from January 2013 to December 2022 were retrieved from Pub Med,Web of Science,Embase,Cochrane,Wan fang,CNKI and VIP.Then,the quality evaluation of the included literature was carried out to extract relevant data,and the statistical analysis was completed by using the Meta analysis software Rev Man5.3.And publication bias was assessed by Egger’s test using Stata17.Results: Part 1: Univariate analysis showed that age(P=0.014),tumor invasion into the capsule(P=0.032),were significantly correlated with the occurrence of SLLNM.Multivariate analysis showed that:tumor Capsule invasion(OR=12.010,95%CI 1.401-102.931,P=0.023<0.05);age≥55(OR=0.128,95%CI 0.025-0.669,P=0.015)was Independent risk factors for skip metastasis;Part 2: 30 articles were included,with a total of 15,221 PTC patients,1,735 cases of SLLNM,and the skip metastasis rate was11.3%.Meta-analysis results showed that women(OR=1.28 95%CI: 1.13-1.44;P<0.0001),age≥45(OR=2.02,95%CI:1.75-2.34;P<0.00001),the tumor was located in the upper pole of the thyroid(OR=3.7795%CI:2.69-5.30;P<0.00001),unilateral glandular lesions(OR=0.65;95%CI:0.49-0.87;P=0.003)tumor extraglandular invasion(OR=1.31;95%CI: 1.10-1.57;P=0.002),tumor diameter≤ 1.0cm(OR=2.55;95%CI:1.86-3.50;P<0.00001)are the reasons for SLLNM in PTC patients risk factors.Multifocal(OR=0.86;95%CI:0.69-1.0;P=0.19),combined with Hashimoto’s thyroiditis(OR=1.09;95%CI:0.94-1.26;P=0.25)had no significant relationship with SLLNM.Conclusion: This study concluded that female,age≥45 years,tumor located in the upper pole of the thyroid,unilateral glandular lobe lesions,tumor extraglandular invasion,and tumor diameter≤1.0cm are risk factors for SLLNM in PTC patients.