Journal of Capital Medical University ›› 2021, Vol. 42 ›› Issue (6): 1053-1059.doi: 10.3969/j.issn.1006-7795.2021.06.024

• Clinical Research • Previous Articles     Next Articles

Cluster analysis of risk factors of central lymph node metastasis in papillary thyroid microcarcinoma

Wang Yajun*, Kang Hua, Zhao Jing, Hai Tao, Zhang Xiaoli, Cai Wei   

  1. Department of Thyroid and Breast Disease Diagnosis and Treatment Center, Xuanwu Hospital, Capital Medical University, Beijing 100053,China
  • Received:2021-08-21 Online:2021-12-21 Published:2021-12-17
  • Contact: * E-mail: wangyajun@xwh.ccmu.edu.cn

Abstract: Objective To investigate the risk factors of central lymph node metastasis in papillary thyroid microcarcinoma (PTMC) by cluster analysis. Methods Totally 481 patients diagnosed with PTMC from January 2015 to June 2019 were enrolled in this study. The clinical features including gender, age, tumor diameter, number of tumors, tumor capsule involvement, cervical lymph node metastasis and comorbid with benign thyroid diseases were analyzed by cluster analysis with SPSS software. Furthermore, validation of cluster analysis was made in order to determine the impact factors of central lymph node metastasis. Results In this study, 481 PTMC patients were involved, including 125 males and 356 females, with the average age of (44.87±12.14) years. 207 PTMC patients were with central lymph node metastasis, and the metastasis rate was about 43.0%. Cluster analysis divided PTMC patients into three clinical categories. In cluster group 1, all patients had no tumor involvement of thyroid capsule, most of them were single tumor, the diameter of tumor was smaller than that of the other two groups, and the rate of lymph node metastasis was the lowest (32.54%). In cluster group 2, the diameter of the tumor was large, the capsule was involved and the lymph node metastasis rate was 38.61%. In cluster group 3, thyroid capsule involvement and multiple tumors was found in all patients (100%), and the lymph node metastasis rate was 57.14%. The results of cluster analysis were further confirmed by univariate correlation analysis and multivariate Logistic regression analysis. Tumor size, number of tumors and thyroid capsule involvement were the impact factors of central lymph node metastasis in PTMC, and thyroid capsule involvement and multiple tumors were the more important factors. Conclusion Central lymph node metastasis is common in PTMC. Tumor size, number of tumors, and thyroid capsule involvement are the impact factors of central lymph node metastasis. Capsule involvement and multiple tumors are more important in the evaluateon of central lymph node metastasis.

Key words: papillary thyroid microcarcinoma, central lymph node metastasis, cluster analysis

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