| Objective To explore the related high-risk factors of lymph node metastasis in zone VIb of papillary thyroid cancer and the value of clinical application. Method To collect and analyze the clinical and pathological data of 82 patients with papillary thyroid cancer admitted to Inner Mongolia Hospital of Peking University Cancer Hospital from April 2024 to December 2024, and analysed to statistically analyse the relationship between the relevant factors and lymph node metastasis in area VIb respectively, as well as focusing on the relationship between lymph node metastasis in area VIa and area VIb. Result Among the 82 patients with papillary thyroid cancer, the lymph node metastasis rate of zone VIa was 51.2%; the lymph node metastasis rate of zone VIb was 30.5%; 28.0% of the patients had lymph node metastasis of zones VIa and VIb at the same time; and among the patients with no lymph node metastasis of zone VIa, the rate of lymph node metastasis of zone VIb was only 5.0%. The results of univariate analysis showed that diameter, perineural invasion, lymph nodes in area VIa, pre-laryngeal lymph nodes, and pre-tracheal lymph nodes were associated with lymph node metastasis in area VIb, and the difference was statistically significant (P < 0.05). The results of multifactorial analysis showed that pre-laryngeal lymph nodes as well as metastatic lymph nodes in area VIa were independent risk factors for metastatic lymph nodes in area VIb, and the difference was statistically significant (P < 0.05). The areas under the curve of the subject's work characteristics (ROC) curves for the number of metastatic lymph nodes in zone VIa, the number of metastatic lymph nodes in the anterior larynx, and the combination of the two to predict metastasis of lymph nodes in zone VIb were 0.750 (95% CI: 0.633-0.868), 0.615 (95% CI: 0.457-0.772), and 0.815 (95% CI: 0.723-0.907). Conclusion When metastasis was found in anterior laryngeal lymph nodes and lymph nodes in area VIa in patients with papillary thyroid cancer, it was highly suggestive of metastasis in lymph nodes in area VIb, and lymph node clearance in area VIb could be routinely performed in patients with high-risk factors. |
