Analysis Of Risk Factors Related To Lymph Node Metastasis Of Papillary Thyroid Microcarcinoma

Purpose: To explore the risk factors that may predict the lymph node metastasis potential of these lesions in papillary thyroid microcarcinoma(PTMC),which may provide certain ideas and basis for clinical diagnosis and treatment.Methods: Retrospectively analyze the clinicopathological data of 123 patients with PTMC who have undergone surgical treatment of glands in the Affiliated Hospital of Youjiang Medical University for Nationalities,pathologically confirmed and meet the inclusion criteria,and grouped according to whether cervical lymph node metastasis has occurred,and analyzed the related risks of PTMC lymph node metastasis factor.Results: Among 123 patients with PTMC,52 patients(42.3%)had lymph node metastasis,and 71 patients(57.7%)had no lymph node metastasis.The results of single factor analysis showed that morphology,tumor maximum diameter,border,internal echo),microcalcification,blood flow signal,aspect ratio,capsule invasion,preoperative thyroid stimulating hormone level and BRAFV600 E gene mutation were statistical differences between the non-metastasis group and the metastasis group(P<0.05),which were risk factors for lymph node metastasis in patients with PTMC;age,gender,body mass index,tumor location,number of lesions,thyroglobulin,combined with Nodular goiter,Hashimoto's thyroiditis,and thyroid adenoma were not statistically different between the two groups(P>0.05).The results of multivariate regression analysis showed that capsule invasion(OR=27.572,95%CI=2.055-369.925,P=0.012),and elevated preoperative serum TSH level(OR=1.043,95%CI=1.015-1.073,P=0.03)And BRAFV600 E gene mutation(OR=46.97195%CI=6.0737-365.482,P<0.001)are independent risk factors for lymph node metastasis inpatients with PTMC(both P<0.05).According to the independent risk factor indicators,the joint predictive factors were calculated,and the ROC curve was traced to obtain the area under the curve AUC=0.967,95%CI=0.918-0.991.Conclusion: Elevated preoperative serum TSH level,envelope infringement and BRAFV600 E gene mutation are independent risk factors for lymph node metastasis in patients with PTMC,which can be used as important indicators for clinical prognosis,but further research and verification are still needed.