Observational Study On The Pattern Of Lymph Node Metastasis In The Central And Lateral Cervical Regions Of Superior Pole Thyroid Cancer

Objective(s):This study collected clinicopathological data of superior pole thyroid cancer,analyzed the data,explored the pattern of lymph node metastasis in its central and lateral cervical regions,and provided preliminary clinical data to support the intraoperative lymph node dissection of superior pole thyroid cancer.Method(s):The clinicopathological data of 83 patients with solitary superior pole thyroid cancer from September 2020 to September 2022 at the Affiliated Hospital of Guilin Medical Colleg were collected,and 129 patients with inferior pole thyroid cancer were controlled during the same period.The number of lymph node metastasis in the central region,the number of lymph node metastasis in the lateral cervical region(II,III,IV),the rate of lymph node metastasis in the central region,the rate of lymph node metastasis in the lateral cervical region(II,III,IV)and general clinical data were collected for statistical analysis to find out the association between lymph node metastasis in the central region and the lateral cervical region,to explore the pattern of lymph node metastasis,and to analyze the factors related to lymph node metastasis by single-factor and multi-factor.Result(s):1.A total of 47 cases of 1.83 epipolar thyroid cancers had central metastasis,which was about(47/83)56.63%,and 36 cases were negative for the epipolar central region,accounting for(36/83)43.37%.A total of 31 cases had both Central Lymph Node Metastasis(CLNM)and Lateral Lymph Node Metastasis(LLNM),accounting for(31/47)65.96%;among them,Zone II accounted for(22/31)Two cases had no lymph node metastasis in the central region and 2 cases had lymph node metastasis in the lateral cervical region,accounting for 2.41%(2/83).2.The upper pole thyroid carcinoma was more likely to metastasize to the lateral neck II(P<0.001)area when LLNM occurred,and the difference was statistically significant.3.When the tumor size was >1 cm,upper pole thyroid carcinoma was more likely to develop CLNM(P<0.001)and LLNM(P<0.001)than lower pole carcinoma,which was statistically significant.4.Univariate analysis of upper pole carcinoma: LLNM was significantly associated with CLNM(P=0.001),tumor size(P=0.004),and perineural invasion(P=0.001);CLNM was significantly associated with LLNM(P<0.001),tumor size(P<0.001),and perineural invasion(P=0.014).5.Multifactorial analysis of upper pole carcinoma: CLNM(OR=21.886,95% CI 3.965-120.821,P <0.001),and perineural invasion(OR=4.676,95% CI1.034-21.140,P = 0.045)were independent risk factors for LLNM.Conclusion(s):1.LLNM occurs in upper pole thyroid carcinoma with a tendency to zone II lymph node metastasis.2.When CLNM occurs in the upper pole of the thyroid,LLNM is very likely to occur at the same time.3.When the tumor size is >1 cm,carefully evaluate whether the lymph nodes in the neck area on the side of the upper pole cancer have metastasized.