A study on the correlation between the age of diagnosis and the neck central lymph node metastases in papillary thyroid microcarcinomas

LI Xiao-jing; YANG Le; MA Bin-lin

doi:10.19538/j.cjps.issn1005-2208.2017.09.19

Abstract：Objective To determine the pathologic characteristics and predictive factors that increased the neck cental lymph node metastasis (CLNM)in papillary thyroid microcarcinoma (PTMC).Especially,to determine the correlations between age and the neck central lymph node metastases at different age cutoffs,and the real relation between age and the central lymph node metastases in papillary thyroid microcarcinomas.Methods The clinical and pathologic data collected from 1988 patients who were firstly diagnosed with PTMC at the Affiliated Tumor Hospital of Xinjiang Medical University between January 2010 and March 2016 were analyzed retrospectively.Chi-square test,the curve of receiver operating characteristic (ROC) and multivariate Logistic regression analysis were used to identify the risk factors of the neck central lymph node metastasis.Age at diagnosis was cut from 25 to 70 years at 5-years intervals and was cut from 30 to 60 years at 1-years intervals again,in order to determine the correlations between age and the central lymph node metastases in papillary thyroid microcarcinomas.Results Of all 1988 patients,34.9％ had the neck central lymph node metastasis,and the rate of the neck central lymph node metastasis declined with the age increasing.However,in papillary thyroid microcarcinomas,except for age cutoff of 70 years,age was independently correlated with the neck cental lymph node metastasis at different age cutoffs which was from 25 to 70 years at 5-years intervals or from 30 to 60 years at 1-years intervals.Multivariate logistic regression analysis indicated that male,the number of focality ≥ 3,tumor diameter ＞ 5 mm,unifocal tumor location in the lower third of the thyroid lobe,capsular invasion were independently correlated with the neck central lymph node metastasis (P＜0.05).Conclusion Age at diagnosis,not being a cutoff,only reflects variation tendency.And regarding age as continuous variable is more superiority in the study between age and the central lymph node metastases in papillary thyroid microcarcinom.Then,more aggressive treatment or more frequent follow-up could be considered for patients with unfavorable features (male,the number of focality ≥3,tumor diameter ＞ 5 mm,capsular invasion,unifocal tumor location in the lower third of the thyroid lobe),as the patients may be at an increased risk for the neck cental lymph node metastasis.