AUTHOR=Mao Jingxin , Zhang Qinghai , Zhang Haiyan , Zheng Ke , Wang Rui , Wang Guoze 

TITLE=Risk Factors for Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Endocrinology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.00265

DOI=10.3389/fendo.2020.00265

ISSN=1664-2392

ABSTRACT=<p><bold>Purpose:</bold> To explore the risk factors that may predict the lymph node metastasis potential of these lesions and new prevention strategies in papillary thyroid carcinoma patients.</p><p><bold>Materials and Methods:</bold> In total, 9,369 papillary thyroid carcinoma patients with 37.17% lymph node metastasis were analyzed (Revman 5.3 software) in this study. The PubMed and Embase databases were used for searching works systematically that were published through to January 22, 2020.</p><p><bold>Results:</bold> Several factors were related to the increased risk of lymph node metastasis in patients with papillary thyroid carcinoma: age &lt;45 years (pooled OR = 1.52, 95% CI = 1.14–2.01, <italic>p</italic> &lt;0.00001); gender = male (pooled OR = 1.68, 95% CI = 1.51–1.87, <italic>p</italic> &lt;0.00001); multifocality (pooled OR = 2.05, 95% CI = 1.45–2.89, <italic>p</italic> &lt;0.0001); tumor size ≥1.0 cm (pooled OR = 3.53, 95% CI = 2.62–4.76, <italic>p</italic> &lt;0.00001); tumor location at the upper pole 1/3 (pooled OR =1.46, 95% CI = 1.04–2.04, <italic>p</italic> = 0.03); capsular invasion + (pooled OR = 3.48, 95% CI = 1.69–7.54, <italic>p</italic> = 0.002); and extrathyroidal extension + (pooled OR = 2.03, 95% CI= 1.78–2.31, <italic>p</italic> &lt;0.00001). However, tumor bilaterality (pooled OR = 0.85, 95% CI = 0.54–1.34, <italic>p</italic> = 0.49) and Hashimoto's thyroditis (pooled OR = 1.08, 95% CI = 0.79–1.49, <italic>p</italic> = 0.62) showed no correlation with lymph node metastasis in papillary thyroid carcinoma patients.</p><p><bold>Conclusion:</bold> The systematic review and meta-analysis defined several significant risk factors of lymph node metastasis in papillary thyroid cancer patients: age (&lt;45 years), gender (male), multifocality, tumor size (&gt;1 cm), tumor location (1/3 upper), capsular invasion, and extra thyroidal extension. Bilateral tumors and Hashimoto's thyroiditis were unrelated to lymph node metastasis in patients with papillary thyroid cancer.</p>