Risk factors associated with lymph node metastasis in patients with small papillary thyroid carcinomas.

Objective: This study aims to analyze risk factors for central lymph node metastasis (CLNM) in patients with small papillary thyroid carcinoma (PTC).

Methods: The clinicopathologic data of 375 patients with small PTC admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2017 to December 2020 were analyzed retrospectively. The patients were divided into two groups, namely, CLNM (n = 177) and non-CLNM (n = 198) groups. Relevant data from the two groups were analyzed using the chi-square test, logistic regression analysis, and the receiver operating characteristic (ROC) curve.

Results: The CLNM rate of the 375 patients with small PTC was 47.2%. The chi-square test revealed that CLNM status was correlated with a patient's gender and age as well as tumor size, number of lesions, and invasion of the thyroid capsule (P < 0.05), but not with BRAF gene mutation, Hashimoto's thyroiditis (HT), or nodular goiter. Multivariate analysis indicated significant differences in gender, maximum tumor diameter, multifocality, and thyroid adventitial infiltration between the two groups (all P < 0.05) but no significant difference between the two groups in regard to HT and nodular goiter. The ROC curve suggested that age ≤ 26.5 years and maximum tumor diameter ≥ 0.75 cm were thresholds for increased risk of CLNM.

Conclusions: Lymph node metastasis in the central area of small PTC is associated with multiple factors. Careful examination, analysis, and evaluation of these factors can help in developing accurate individualized treatment strategies.