Lymph Node Metastasis Rate In Central Area Of Thyroid Micropapillary Carcinoma Associated Risk Factors

Purpose: With the medical popularization and advances in technology,the incidence of thyroid cancer has been rising steadily.Papillary thyroid carcinoma(PTC)is found to be one of the most common histological types of thyroid cancer,accounting for above 80% of all new cases,while more than 50% of PTC is papillary thyroid microcarcinoma(PTMC).Yet there is no consensus on how to best manage PTMC,especially on the treatment of central lymph nodes in PTMC patients.This study explored the metastasis rate and related risk factors of central lymph nodes in PTMC,so as to provide reference for prophylactic central lymph node dissection(p CLND).Methods:Retrospective analysis was made on the clinical data of 932 cases confirmed by surgery and pathology in the east campus of the Second Hospital of Hebei Medical University from May 2013 to December 2019.Analysis was carried out using SPSS 25.0.Data were analyzed by two-sample t-test,MannWhitney U test,chi-square test or Fisher's accurate test,logistic regression model and ROC curve.P<0.05 was considered to be statistically significant.Results: 1.The metastasis rate of central lymph node in PTMC was 33.6%(313 cases).2.The result of single-factor analysis on all the data showed that gender,age,maximum diameter and number of lesions were the possible factors impacting on metastasis(P<0.05).3.The multi-factor analysis on all the data showed that gender,age,maximum diameter and number of lesions were the independent factors influencing metastasis(P<0.05),among which age was the protective factor,while gender,maximum diameter and number of lesions were the risk factors.4.The single-factor analysis on single lesion data showed that,gender,age,maximum diameter,and location were possible influencing factors on metastasis(P<0.05).5.The multi-factor analysis on single lesion data showed that,independent factors influencing the metastasis were gender,age,maximum diameter and location(P<0.05).Among them,age was the protective factor,while gender and maximum diameter were the risk factors;upper and middle pole were the protective factors relative to the lower pole;no significant difference was found between the isthmus and the lower pole.6.ROC curve showed that the age > 42.5 years was less prone to metastasis;while the maximum diameter > 0.75 cm was more prone to metastasis.Conclusion:The metastasis rate of central lymph node in PTMC was 33.6%.According to single-factor analysis,possible independent risk factors influencing central lymph node metastasis(CLNM)were gender,age,maximum diameter,number and location of lesions.Patients with male,?42.5 year's old,> 0.75 cm in diameter,multiple lesions,lesions located in the lower pole and isthmus were easily suffered from CLNM.