Risk factors for high-volume lymph node metastases in cN0 papillary thyroid microcar-cinoma
10.3969/j.issn.1000-8179.2017.16.352
- VernacularTitle:cN0甲状腺微小乳头状癌多个淋巴结转移的危险因素分析
- Author:
Lei ZHANG
;
Jinbao YANG
;
Qinghe SUN
;
Yuewu LIU
;
Ge CHEN
;
Shuguang CHEN
;
Ziwen LIU
;
Xiaoyi LI
- Keywords:
papillary thyroid microcarcinoma;
cN0;
high-volume lymph node metastasis;
risk factors
- From:
Chinese Journal of Clinical Oncology
2017;44(16):805-809
- CountryChina
- Language:Chinese
-
Abstract:
Objective: Lymph node metastasis (LNM) often occurs in cN0 papillary thyroid microcarcinoma (PTMC). The risk factors for lymph node metastasis, especially for high-volume metastasis, were investigated in this study. Methods: The medical records of 1,268 consecutive PTMC patients admitted in the Peking Union Medical College Hospital from 2013 to 2014 were reviewed. Their clinical and pathological features were collected. Univariate and multivariate analyses were performed to identify the risk factors for LNM/highvolume LNM. Results: Of the 1,268 patients, 416 patients (32.8％) and 43 (3.4％) had LNM and high-volume LNM, respectively. According to the univariate analysis results for the risk factors of LNM, male (42.22％ vs. 30.26％, P<0.01), <40 years (<40 years, 48.39％; 40-59 years, 27.62％; ≥60 years 22.45％, P<0.03), multifocality (41.00％ vs. 29.03％, P<0.01), without chronic thyroiditis (36.44％ vs. 20.62％,P<0.01), tumor size >0.5 cm (35.77％ vs. 23.05％, P<0.01) were associated with LNM. Meanwhile, according to the multivariate analysis results, male, multifocality, and tumor size >0.5 cm are independent risk factors for LNM (OR=1.516, 1.743, and 1.788, respectively, all P<0.05). The protective factors for LNM are 40-59 years, ≥60 years, and chronic thyroiditis (OR 0.388, 0.301, and 0.472, respectively,all P<0.05). In the univariate analysis of risk factors for high-volume LNM, the results indicated that being male (6.30％ vs. 2.61％, P= 0.005), <40 years (<40 years, 7.62％; 40-59 years, 2.05％; ≥60 years 0, P<0.001), and tumor size >0.5 cm (4.01％ vs. 1.36％, P=0.027) are associated with high-volume LNM. In multivariate analysis, the results suggest that being male is an independent risk factor for LNM (OR=2.383, P=0.002), whereas age of 40-59 years is a protective factor for LNM (OR=0.270, P<0.001). Conclusion: Lymph node metastasis often ocucrs in cN0 PTMC, whereas high-volume LNM is rare. Being male and <40 years old are risk factors for both LNM and highvolume LNM.
