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Objective To investigate the risk factors of lymph node metastasis in papillary thyroid carcinoma (PTC)patients who had thyroid nodule operation. Methods The clinical data of 4742 patients, who had surgical treatment for thyroid nodule from January 2016 to December 2020 in the First Medical Center of Chinese PLA General Hospital, were collected for retrospective study. The pathologic specimens of thyroid and lymph nodes of all the patients were retained during surgery. The patients were divided into metastasis group (n=2407) and non-metastasis group (n=2335) according to lymph node metastasis. The differences of age, sex, body mass index, thyroid stimulating hormone (TSH) value, tumor diameter, capsule invasion, and range of glandular lobe involvement were analyzed between the two groups. The independent risk factors for lymph node metastasis of papillary thyroid carcinoma were evaluated by logistic regression, and multivariate regression analysis were performed based on tumor diameter dividing into subgroups of small and non-small cancers. Results In 4742 patients with PTC, the incidence of cervical lymph node metastasis was 50.8% (2407 cases). Multivariate analysis showed that male, age <45 years, increased tumor diameter, external thyroid extension (ETE), and multiple tumors were independent risk factors for cervical lymph node metastasis(P<0.001). BMI (P=0.369), TSH level (P=0.246) and Hashimoto thyroiditis were not associated risk factors. Subgroup analysis showed that unilateral multiple foci was an independent risk factor for lymph node metastasis in non-microcarcinomas (OR=1.67, 95%CI 1.20-2.31, P=0.002), and ETE in microcarcinomas was also a risk factor for lymph node metastasis (OR=1.58, 95%CI 1.27-1.96, P<0.001). Conclusion Male, <45 years old, tumor size ≥9.5 mm, ETE and multiple tumors are independent risk factors for cervical lymph node metastasis in PTC patients.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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