Preoperative and pathological predictive factors of central lymph node metastasis in papillary thyroid microcarcinoma.

ABSTRACT

OBJECTIVE: The aim of this study was to identify clinical and pathological markers of CLNM in persons with clinical lymph node-negative papillary thyroid microcarcinoma(PTMC). MATERIALS AND METHODS: Retrospective data were analyzed from 804 PTMC clinically negative patients who were receiving thyroid surgery in the First Affiliated Hospital at Chongqing Medical University from January 2017 to December 2018. The CLNM-positive and CLNM-negative groups were categorised according to histological evidence of the central lymph node involvement, statistically, risk variables for CLNM were found. RESULTS: 324 (40.3%) individuals were diagnosed with CLNM. Sex (P=0.001), age at diagnosis (P<0.001), tumour size(P=0.029), microcaccificities presence (P=0.003), capsules discontinuity(P=0.002), multi-focality(P=0.001) and (ETE)extrathyroidal extension (P < 0.001) differed substantially from one positive CLNM group to the next. For multivariate analyses, women (odds ratio [OR] = 0.489), age [OR = 0.540] are the independent protective factors for CLNM; micro-cacification presence (OR = 1.511), discontinuity of capsules (OR= 2.056), multifocality(OR=1.486) and ETE(OR=10.613) are the independent risk factors for CLNM. Feature curves of the receiver were built and the AUC is 0.763. 32.1% percent (80 patients) of the 249 patients who did not have any of the four risk variables got CLNM. This contrasted with the incidence of CLNM in this research, which was as high as 49.1%. CONCLUSIONS: CLNM has been connected with female sex, age - within 45 years, microcacification occurrences, capsule discontinuity, multifocality and extrathyroid expansion. The patients may benefit from the surgical decision of pCLND whether there are risk factors combined.