Clinical analysis of papillary thyroid carcinoma (diameter>1 cm) with lateral cervical lymph node metastasis in 155 cases
10.3760/cma.j.cn115807-20231103-00129
- VernacularTitle:直径1 cm以上甲状腺乳头状癌侧颈淋巴结转移155例临床分析
- Author:
Yiwei WANG
1
;
Shengying WANG
Author Information
1. 安徽省肿瘤医院头颈乳腺外科，合肥 230001
- Keywords:
Papillary thyroid carcinoma;
Lateral cervical lymph node metastasis;
Single-level metastasis
- From:
Chinese Journal of Endocrine Surgery
2024;18(4):510-514
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the regularity and related influencing factors of lateral cervical lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC) with primary lesion > 1 cm, and to guide clinical diagnosis and treatment.Methods:The clinicopathological data of 155 PTC patients with primary lesion > 1 cm and LLNM who underwent radical surgery in Anhui Cancer Hospital from Jan. 2022 to Dec. 2022 were retrospectively analyzed. The observation indicators were as follows: gender, age, operation method, number of primary lesions, maximum diameter, location, Hashimoto's thyroiditis (HT), total number and positive number of lymph nodes in central and lateral cervical regions, proportion and rate of metastasis. The measurement data were analyzed by t test, and the count data were analyzed by χ2 test. Pearson correlation analysis and multivariate regression analysis were used to evaluate the influencing factors of lymph node metastasis. Results:The maximum diameter of PTC in 155 cases was (19.67±8.15) mm. A total of 1933 central lymph nodes were dissected, with metastasis ratio of 91.61% and average metastasis rate of 50.77%±29.14%. A total of 5371 lateral lymph nodes were dissected, with an average metastasis rate of 14.44%±9.89%. The proportion of LLNM in level III and level IV was 70.97% and 60.10% respectively, and the positive rate was 19.51% and 17.07% respectively. 43 cases were single-level LLNM, including 23 cases of single-level oligometastasis. There was a positive correlation between central lymph node metastasis (CLNM) rate and LLNM rate (Pearson=0.28, P=0.000). Gender ( P=0.022), age ( P=0.038), number of lesions ( P=0.025), maximum diameter of lesions ( P=0.002), and HT ( P=0.000) were independent factors of CLNM rate. Among the factors influencing the LLNM rate, only the maximum diameter of lesion showed statistical significance ( P=0.040). Single-level LLNM was only associated with HT ( P=0.034). HT ( OR=3.515, P=0.008) and single lesion ( OR=3.217, P=0.047) were independent factors for single-level oligometastasis. Conclusions:In PTC cases with primary lesion > 1 cm, LLNM rate is positively correlated with that of CLNM. LLNM occurres most frequently in level III and level IV. Single-level LLNM is more likely to occur in patients with HT, and when there’s a single focus, single-level oligometastasis is more likely to occur. Accurate preoperative evaluation should be emphasized for such patients.
