Prediction of bilateral thyroid carcinoma and lateral cervical lymph node metastasis in PTC patients with suspicious thyroid nodules

This study aimed to evaluate the factors associated with bilateral papillary thyroid carcinoma (PTC) and lateral cervical lymph node metastasis (LLNM) in patients with suspicious unilateral PTC.

This study analyzed patients with suspicious unilateral PTC who were enrolled in a university hospital between 2016 and 2019 in Zhejiang, China. Using logistic regression, the study examined the factors associated with bilateral PTC and LLNM in demographic data, anthropometric measurements, lifestyle factors, medical history, preoperative diagnostic tests, and histopathological factors.

A total of 256 patients, with a mean age of 49 years, were enrolled. Bilateral PTC was associated with multifocality (aOR: 5.069, 95% CI: 2.440–10.529, P < 0.001), and contralateral nodule in the upper (aOR: 9.073, 95% CI: 2.111–38.985, P = 0.003) and middle (aOR: 9.926, 95% CI: 2.683–36.717, P < 0.001). LLNM was positively associated with bilateral PTC (aOR, 4.283, 95% CI: 1.378–13.308, p = 0.012), male (aOR, 3.377, 95% CI: 1.205–9.461, P = 0.021), upper location of carcinoma (aOR, 3.311, 95% CI: 1.091–10.053, p = 0.035), and punctate echogenic foci (aOR, 3.309, 95% CI: 1.165–9.394, P = 0.025). Contralateral maximal nodule in the upper (aOR: 0.098, 95% CI: 0.015–0.628, p = 0.014), middle (aOR: 0.114, 95% CI: 0.033–0.522, p < 0.001), and lower (aOR, 0.028, 95% CI: 0.003–0.276, P = 0.002) location were inversely associated with LLNM.

Upper and middle location of contralateral nodule and tumor multifocality predicted the risk bilateral PTC. Bilateral PTC, male, upper tumor location, punctate echogenic foci and contralateral nodule location in the entire lobes were independent predictors for LLNM.