Clinical analysis of cervical lymph node metastasis patterns and multivariate factors in differentiated thyroid carcinoma

Abstract

The incidence rate of thyroid cancer is rising rapidly in numerous parts of the world, but the mortality rate is rela‑ tively stable or even declining. The aim of the present study was to analyze the risk factors of cervical lymph node metas‑ tasis (LNM) in differentiated thyroid carcinoma (DTC). The clinical data of 846 patients with DTC were collected from the Department of General Surgery of Chifeng Municipal Hospital of Inner Mongolia Medical University (Chifeng, China) from June 2018 to June 2022. The relationship between central LNM (CLNM) and lateral LNM (LLNM) was explored in terms of sex, age, tumor diameter, multifocality, capsular invasion and Hashimoto's thyroiditis. It was revealed that male sex, age <35 years, tumor size >1 cm, multifocality and capsular inva‑ sion were associated with CLNM and LLNM (P<0.001), while there was no relationship between Hashimoto's thyroiditis, CLNM and LLNM (P>0.05). The number of positive lymph nodes in CLNM dissection, accounting for ≥50% of the total number of lymph nodes dissected, was significantly associated with LLNM (P<0.0001). In conclusion, there was no correla‑ tion between Hashimoto's thyroiditis and CLNM and LLNM. The present study revealed that patients with the characteris‑ tics of sex, age <35 years, tumor size >1 cm, multifocality and capsular invasion were associated with cervical LNM. The proportion of the number of central lymph node metastases to the total number of lymph nodes cleared during surgery is more than or equal to 50%, indicating a susceptibility to external cervical lymph node metastasis. The results of multi‑ variate logistic analysis showed that male sex, multifocality, capsular invasion and CLNM were risk factors for LLNM, and age was a protective factor for LLNM in DTC.