Background: Skip metastasis, regarded as lateral lymph node metastasis (LLNM) without involving the central lymph node metastasis (CLNM), in papillary thyroid carcinoma (PTC) patients is commonly unpredictable. The purpose of the present research was to investigate the independent risk factors of skip metastasis in patients with PTC.
Methods and Materials: In the present research, 228 consecutive PTC patients who experienced total thyroidectomy coupled with central and lateral lymph node dissection from May 2020 to September 2022 at the Affiliated hospital of Jiangsu University were included in our research. Univariate and multivariate analysis were then applied to investigate the risk factors of skip metastasis in patients with PTC. Furthermore, a predictive model of skip metastasis was then constructed based on risk factors.
Results: The skip metastasis rate was 11.8% (27/228) in the current research. After the univariate and multivariate analysis, tumor size ≤ 10 mm, unilaterality, microcalcification, and upper tumor location were determined to be predictive factors of skip metastasis. The risk score of skip metastasis was calculated: risk score = 1.229 × (if tumor nodule ≤ 10mm) + 1.518 × (if unilaterality nodule) + 1.074 × (if microcalcification in nodule) + 2.332 × (if nodule in upper location).
Conclusion: Tumor size ≤ 10 mm, unilaterality, microcalcification, and upper tumor location can increase the occurrence of skip metastasis in patients with PTC, which is expected to provide useful information to guide the suitable intraoperative window.



中文翻译：

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结合临床病理学和超声特征预测甲状腺乳头状癌外侧淋巴结跳跃转移

背景：甲状腺乳头状癌（PTC）患者的跳跃转移，被视为侧向淋巴结转移（LLNM），不涉及中央淋巴结转移（CLNM），通常是不可预测的。本研究的目的是探讨PTC患者跳跃转移的独立危险因素。
方法和材料：本研究连续纳入2020年5月至2022年9月在江苏大学附属医院接受甲状腺全切除加中央和侧方淋巴结清扫术的228例PTC患者。然后应用单因素和多因素分析探讨PTC患者跳跃转移的危险因素。此外，基于危险因素构建了跳跃转移的预测模型。
结果：本研究中的跳跃转移率为11.8%（27/228）。经过单因素和多因素分析，肿瘤大小≤10 mm、单侧、微钙化和肿瘤位置较高被确定为跳跃转移的预测因素。计算跳跃转移风险评分：风险评分=1.229×（如果肿瘤结节≤10mm）+1.518×（如果单侧结节）+1.074×（如果结节内有微钙化）+2.332×（如果结节位于上部）。
结论：肿瘤大小≤10 mm、单侧性、微钙化、肿瘤位置较高可增加PTC患者跳跃转移的发生率，有望为指导合适的术中窗口提供有用信息。