Acta Med. 2017, 60: 44-50

https://doi.org/10.14712/18059694.2017.49

Papillary Thyroid Carcinoma: Analysis of the Central Compartmentʼs Lymph Nodes Metastases

Ján Sojaka,b,c, Marian Sičákc, Adrian Kališd, Michal Slašťane

aBiomedical Centre Martin JFM CU, Slovakia
bComenius University in Bratislava, Jessenius Faculty of Medicine in Martin (JFM CU), Department of Pathological Physiology JFM CU, Slovakia
cSlovak Medical University in Bratislava, Faculty of Medicine, The Clinic of Otorhinolaryngology and Head and Neck Surgery, Central Military Hospital in Ružomberok, Slovakia
dCatholic University in Ružomberok, Faculty of Health, Department of Pathological Anatomy, Central Military Hospital in Ružomberok, Slovakia
eDepartment of Medical Biochemistry JFM CU, Slovakia

Received November 25, 2016
Accepted December 20, 2016

Background: Papillary thyroid carcinoma is typical by regional lymph nodes metastases. Therefore we decided to analyse associated risk factors. Objective: In this retrospective study we focused on the incidence of metastatic involvement of the central compartment’s lymph nodes correlated with age, size of the primary tumour, infiltration of thyroid gland capsule, positive lymphangioinvasion in order to assess risk factors. Method: We analysed group of 156 patients with papillary carcinoma, who have undergone total thyroidectomy and bilateral elective central compartment neck dissection. We evaluated the occurrence of metastases, size, infiltration and lymphangioinvasion based on definitive histology of the whole group and separately for subgroups of patients under and over 45 years. Result: We found metastatic involvement in 88 (56.4%) patients. When comparing the subgroups of patients under (73 patients) and over 45 years (83 patients), we found metastases in 56 vs. 32 (76.7% vs. 38.6%) patients. In the subgroup of younger patients we found significant higher incidence of metastases compared with the group of over 45 years, P < 0.001 (P = 0.000027). We found significant higher incidence of metastases in patients with positive capsule infiltration in the whole group, P < 0.001 (P = 0.00049); in the subgroup of under 45 years, P < 0.001 (P = 0.00091) and in patients with positive lymphangioinvasion in the whole group, P < 0.01 (P = 0.00177); in the subgroup of over 45 years, P < 0.001 (P = 0.0002). In patients with metastases we found tumour size ≥1cm more frequently in all groups. Conclusion: We recorded higher incidence of regional metastases in patients under 45 years, positive capsule infiltration, lymphangioinvasion. Age under 45 years itself does not correlate with less aggressive disease, to the contrary some of other analysed risk factors correlate with more aggressive disease.

References

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