[Clinical features of papillary thyroid carcinoma patients associated with lateral lymph node metastasis in different...

Objective:To explore the clinical features of papillary thyroid carcinoma(PTC) patients associated with lateral lymph node metastasis(LLNM) in different ages. Method:One hundred and sixtyfive PTC patients associated with LLNM were included in the study and divided into three groups(22-＜30y,30-＜45y and 45-65y). The gender, the number and the ratio of neck lymph node metastasis, maximum tumor diameter, multifocality, preoperative serum thyroid stimulating hormone(TSH), the capsular invasion, extrathyroidal extension and other clinical features in different ages were analyzed.Result:The median age of the patients was 39 years. There were no significant differences in the maximum tumor diameter ＞1cm,multifocality and preoperative serum TSH level among the three groups. The proportion of female patients in 22-＜30y group was higher than the other two groups(all P<0.05).The rate of bilateral lesions in 45-65y group was higher than 22-＜30y group (P<0.01).The rates of the capsular invasion and extrathyroidal extension in 22-＜30y group and 30-45 group were similarly lower than 30-＜45y group(P<0.05).The proportion of the 22-＜30y group coexistent with Hashimoto thyroiditis was higher than the other two groups(P<0.05). When the number of central lymph node metastasis(CLNM)＞3,the proportion of 22-＜30y group were higher than the other two groups(all P<0.01), the 30-＜45y group was the same as higher than 45-65y group(P<0.05); When the ratio of CLNM＞0.35,the proportion of 30-＜45y group was significantly higher than the other two groups(all P<0.05).When the number of LLNM＞6, 22-＜30y group was significantly higher than the other two groups;when the ratio of LLNM＞0.33, 45-65y group was lower than the other two groups(all P<0.05).The total lymph node metastasis＞11, the proportion of 22-＜30y group was significantly higher than the other two groups(all P<0.05), meanwhile 30-＜45y was higher than 45-65y group(P<0.05);when the ratio of total lymph node metastasis＞0.22,45-65y group was significantly higher than the other two groups(all P<0.01).Conclusion: There is a high proportion of female and maximum tumor diameter over 1cm in PTC associated with LLNM. The proportion of coexistent with Hashimoto thyroiditis and the number of lymph node metastasis are much higher in 22-＜30y group. The higher ratio of CLNM is much more common in 30-＜45y group. The bilateral lesions are more likely to occur in 45-65y group, and meanwhile the tumor is more easier to invade the capsular and extrathyroidal construction. The number and the ratio of total lymph node metastasis might be lower in PTC associated with LLNM of older patients.