Influencing factors for contralateral central lymph node metastasis in papillary thyroid carcinoma patients with ipsilateral central lymph node metastasis
10.3760/cma.j.cn113855-20241224-00805
- VernacularTitle:已有同侧中央区淋巴结转移的甲状腺乳头状癌对侧中央区淋巴结转移的影响因素分析
- Author:
Qian ZHANG
1
;
Gaoyang SHI
;
Hui LU
;
Suling WU
;
Hao ZHANG
Author Information
1. 南京医科大学第一附属医院普外科甲状腺中心，南京 210009
- Publication Type:Journal Article
- Keywords:
Thyroid carcinoma ,papillary;
Lymphatic metastasis;
Risk factors
- From:
Chinese Journal of General Surgery
2025;40(10):769-774
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors of contralateral central lymph node metastasis in papillary thyroid carcinoma (PTC) patients with established ipsilateral central lymph node metastasis, and to provide a basis for clinical decision-making on whether to perform contralateral central lymph node dissection.Method:The clinical data of 348 PTC patients who underwent surgery at Jiangsu Provincial People's Hospital from Jun 2018 to Aug 2024 were retrospectively analyzed. Univariate analysis and multivariate Logistic regression analysis were used to determine the independent risk factors affecting the contralateral central lymph node metastasis of PTC with existing ipsilateral central lymph node metastasis.Results:Tumor size was positively correlated with the risk of metastasis. For every one-unit increase in the metastasis rate of the ipsilateral central lymph nodes, the risk of metastasis in the contralateral central region increases by 13.31 times ( P<0.001). Patients with ipsilateral lateral cervical metastasis have a higher risk of contralateral central metastasis ( P=0.026). The contralateral lymph node metastasis rate of patients with Hashimoto was 24%, while that of patients without Hashimoto was 76%( P<0.001). When the tumor was located at the upper pole, the metastasis rate of the contralateral central lymph nodes was 18%; when it was located at the middle pole, it was 29.6%; and when it was located at the lower pole, it was 42.6%( P=0.016). Conclusions:Tumor size, contralateral lateral cervical lymph node metastasis, and the intensity of ipsilateral central lymph node metastasis are independent risk factors for contralateral central lymph node metastasis in PTC patients with existing ipsilateral central lymph node metastasis. Tumor location at the upper pole and the presence of Hashimoto are protective factors.
