关键词: 甲状腺肿瘤, 髓样癌, 侧颈区淋巴结, 淋巴结转移, 风险因素

Abstract: Objective To retrospectively analyze the clinicopathological characteristics and risk factors for lateral cervical lymph node metastasis of medullary thyroid carcinoma （MTC）. Methods A retrospective analysis was conducted on 45 patients with medullary thyroid carcinoma who underwent initial surgery from November 2013 to November 2021 at Sun Yat-sen University′s Sun Yat-sen Memorial Hospital, using a single factor analysis and a multivariate logistic regression model. Results Among the clinicopathological features, the ratio of male to female was 1.25∶1, with 29 （64.4%） lymph node metastases in the central region and 15 （33.3%） lymph nodes in the lateral cervical region. Univariate analysis showed that patients with primary tumor diameter≥1.9 cm, tumor invasion of capsule, and≥4 lymph nodes in the central cervical region considered for metastasis had a significantly higher risk of lateral cervical lymph node metastasis （P<0.05）. In multivariate logistic analysis, the results showed that only the maximum diameter of the tumor affected the probability of lateral cervical lymph node metastasis, with statistical significance （P<0.05）. Conclusion Compared with thyroid papillary carcinoma, the male patients with MTC in this article had a higher incidence rate than the female patients. When the tumor diameter of MTC patients is ≥1.9 cm, the tumor invades the capsule, and the lymph nodes in the central region of the neck are considered to have multiple metastases, the lymph nodes in the lateral region of the neck should be fully evaluated before surgery to avoid omission and secondary surgery.

Key words: thyroid carcinoma, medullary carcinoma, lateral cervical lymph nodes, lymph node metastasis, risk factors