Risk analysis of lymph node metastasis of cN0 papillary thyroid microcarcinoma in region VI and its guiding significance for surgery

ObjectiveTo analyze the risk factors of central lymph node metastasis in cN0 papillary thyroid microcarcinoma (PTMC).

MethodsThe clinical data of 200 patients with cN0 PTMC were collected, which included gender, age, preoperative TSH, BRAF gene mutation or not, tumor diameter, multiple lesions, unilateral/bilateral, combining chronic lymphocytic thyroiditis or not, envelope invasion or not, extragland invasion or not, and postoperative pathology.The patients were divided into lymph node positive group and lymph node negative group according to the central lymph node metastasis or not, and the risk factors of central lymph node metastasis of cN0 PTMC were analyzed.

ResultsUnivariate analysis showed that age, tumor diameter, multiple lesions, envelope invasion, extragland invasion, BRAF gene mutation were associated with central lymph node metastasis in patients with PTMC(P < 0.05 to P < 0.01).Multivariate logistic regression analysis showed that age, tumor diameter, multiple lesions, envelope invasion, and BRAF gene mutation were the independent risk factors for central lymph node metastasis(P < 0.05 to P < 0.01).

ConclusionsFor PTMC patients, if there are clinical features of younger age, larger tumor diameter, multiple lesions, envelope invasion, and positive BRAF gene mutation, the risk of central lymph node metastasis is higher.Even if the preoperative assessment of central lymph node is negative, the scope of surgery should also include the dissection of central lymph nodes to reduce the risk of residual cancer and recurrence.