Journal
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION
Volume 42, Issue 2, Pages 227-236Publisher
SPRINGER
DOI: 10.1007/s40618-018-0908-y
Keywords
Papillary thyroid microcarcinoma; Lymph node metastasis; Neck dissection; Risk factors
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Funding
- Key Project of Scientific and Technological Innovation in Hangzhou [20131813A08]
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PurposeLymph node metastasis (LNM) is a vital prognosis factor in patients with papillary thyroid microcarcinoma (PTMC). The study tried to identify clinicopathological factors for LNM of PTMC.MethodsThe clinicopathological data of 1031 patients with PTMC were extracted and analyzed. Univariate and multivariate analyses were used to identify risk factors associated with cervical lymph node metastasis. ROC analysis was used to determine the ideal critical points of the sum of the maximum diameter of multifocal in a unilateral lobe.ResultsThe probability of LNM, central lymph node metastasis (CLNM) and lateral lymph node metastasis(LLNM)of PTMC patients were 35.6, 33.7 and 5.6%, respectively. In addition, 1.9% PTMC had LLNM only. Male, age40years, tumor largest diameter5mm, multifocal, non-uniform echoic distribution, the sum of the maximum diameter of multifocal in a unilateral lobe8.5mm, tumors in the lower pole location were prone to CLNM. Ultrasound mix-echo, the sum of the maximum diameter of the multifocal10.75mm, tumors in the upper pole location were extremely prone to LLNM. T3 were prone to LLNM or skip LLNM.ConclusionsAccording to the clinicopathological characteristics of PTMC, the cervical lymph nodes should be correctly evaluated to guide the surgical treatment.
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