WU Yayun , ZHANG Kai , CAO Zhimin , DENG Jinbei , LIU Rubin , ZHANG Qiang
  • Department of Head and Neck Surgery, Fuyang Cancer Hospital, Fuyang, Anhui 236000, P. R. China;
WU Yayun, Email: wuyayun@mzdan.com; ZHANG Kai, Email: zhangkai@mzdan.com
papillary thyroid carcinoma; central lymph node metastasis; lateral lymph node metastasis; risk factor
10.7507/1007-9424.202411150
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Objective To investigate the risk factors affecting cervical central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) in patients with papillary thyroid carcinoma (PTC). Methods The patients with newly diagnosed with PTC who underwent surgical treatment in this hospital from April 2020 to December 2023 were included. The univariate and multivariate logistic regression analyses were conducted to identify the risk factors affecting the occurrences of CLNM and LLNM in patients with PTC and a prediction model was developed using these risk factors. Additionally, the discriminatory power of the predictive model for CLNM or LLNM was evaluated using the area under the receiver operating characteristic curve (AUC). Results A total of 297 patients with PTC were included in this study, among whom 149 (50.2%) cases developed CLNM, and 41 (13.8%) cases developed LLNM. The multivariate analysis indicated that the male, age <36 years old, and maximum tumor diameter >5 mm were the independent risk factors for CLNM in the patients with PTC (P<0.05). The independent risk factors for LLNM in the patients with PTC were the age ≥59 years old, bilateral or isthmus distribution of cancer foci, maximum tumor diameter >5 mm, and invasion of capsule (P<0.05). The AUC (95%CI) of the CLNM prediction model, constructed using three risk factors (gender, age, and maximum tumor diameter), was 0.693 (0.633, 0.752). For the LLNM prediction model, which incorporated four factors [age, distribution of cancer foci, maximum tumor diameter, and capsular invasion], the AUC (95%CI) was 0.776 (0.707, 0.846). Conclusions The findings of this study suggest that younger male patients with PTC (age <36 years), and a maximum tumor diameter >5 mm have a higher risk of CLNM. However, the predictive model constructed for CLNM demonstrates only moderate discriminatory power. In contrast, elderly patients (age ≥59 years old) with PTC exhibiting a maximum tumor diameter >5 mm, capsular invasion, and bilateral (or isthmus) lesions are at greater risk of LLNM. The predictive model developed for LLNM shows a certain discriminatory performance.

Citation： WU Yayun, ZHANG Kai, CAO Zhimin, DENG Jinbei, LIU Rubin, ZHANG Qiang. Analysis of risk factors for cervical central and lateral lymph node metastases in patients with papillary thyroid carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2025, 32(6): 769-774. doi: 10.7507/1007-9424.202411150 Copy

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