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[Risk factors analyses for lateral neck lymph node metastasis in papillary thyroid carcinoma].

Z J Qi1, L F Liu, L Cheng

  • 1Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi = Journal of Clinical Otorhinolaryngology Head and Neck Surgery
|July 23, 2019
PubMed
Summary

Papillary thyroid carcinoma (PTC) patients with larger tumors (>1.0 cm), upper lobe tumors, and central neck lymph node metastasis face higher risks of lateral neck lymph node metastasis (LNM). Two or more risk factors significantly increase LNM probability.

Keywords:
lymph node metastasispapillary thyroid carcinoma

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Area of Science:

  • Oncology
  • Surgical Pathology
  • Diagnostic Imaging

Background:

  • Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy.
  • Lateral neck lymph node metastasis (LNM) is a critical prognostic factor in PTC.
  • Identifying risk factors for lateral LNM is essential for appropriate treatment planning.

Purpose of the Study:

  • To investigate the clinical and ultrasound characteristics associated with lateral LNM in PTC patients.
  • To identify significant risk factors predicting lateral LNM in papillary thyroid carcinoma.

Main Methods:

  • Retrospective review of 145 PTC patients, categorized into lateral LNM-positive and negative groups.
  • Analysis of clinical factors, tumor ultrasound characteristics, and final pathology results.
  • Univariate and multivariate analyses to determine independent risk factors for lateral LNM.

Main Results:

  • Primary tumor size (>1.0 cm), upper portion location, and central neck lymph node metastasis were significant risk factors for lateral LNM (OR=6.250, 4.881, 5.222; P<0.05).
  • Lateral LNM was not significantly correlated with gender, age, capsule invasion, multifocality, or specific ultrasound features.
  • The probability of lateral LNM increased to 38.1% when two or more risk factors were present.

Conclusions:

  • Tumor size >1.0 cm, upper lobe location, and positive central compartment lymph node metastasis are key predictors of lateral LNM in PTC.
  • The presence of multiple risk factors substantially elevates the likelihood of lateral neck metastasis.
  • Individualized lymph node dissection strategies should consider these high-risk factors and detailed ultrasound evaluations.