Analysis of Risk Factors of Neck Nodal Metastasis in Patients with Papillary Thyroid Microcarcinoma

ABSTRACT

Objective: The aim of this study was to evaluate the risk factors of neck nodal metastasis on papillary thyroid microcarcinoma patients.

Material and Methods: About 123 patients diagnosed with thyroid papillary microcarcinoma, who had undergone total thyroidectomy, between January 2012 and December 2014, were analyzed retrospectively for neck nodal metastasis and distant metastasis risk factors. Laboratory and surgical data were collected for these patients. Other factors such as gender, age, levels of anti-thyroid peroxidase and anti-thyroglobulin antibodies, thyroid stimulating hormone, level of thyroglobulin on thyroid stimulating hormone suppression, size of tumor, presence of capsular invasion, extrathyroidal extension, metastasis of central neck lymph node, vascular invasion, multifocality, bilateral involvement, size of preoperative node, duration of the disease, radioactive iodine therapy, metastasis of lateral neck lymph node and histopathological type were investigated.

Results: Among the cases that were studied, there were 104 (84.6%) females and 19 (15.4%) males. Their average age was 48.60±12.05 years and the mean tumor size was 6.06±2.63 mm. In patients with lateral neck lymph node metastasis and capsular invasion, the thyroglobulin levels after thyroid stimulating hormone suppression were higher. The rate of total neck lymph node metastasis was found to be higher in patients with capsular invasion. Furthermore, the Anti-thyroid peroxidase levels were higher in thyroid papillary microcarcinoma patients who did not have lateral lymph node metastasis.

Conclusion: The thyroglobulin levels after thyroid stimulating hormone suppression and capsular invasion are important risk factors for neck nodal metastasis, in papillary thyroid microcarcinoma patients.