Abstract:Objective To explore the risk factors for cervical lymph node metastasis in papillary thyroid microcarcinoma (PTMC). Methods Clinical data of 1 363 PTMC patients were treated surgically from Jan.2010 to Mar.2020 the First Affiliated Hospital of Xi'an Jiaotong University,otolaryngology head and neck. The clinicopathological features between the two groups,including patients' gender and age, tumor size, multiple foci, extrathyroidal extensive (ETE), tumor location, cervical lymph node metastasis, as well as the relationship between BRAFV600E mutation and cervical lymph node metastasis, were compared and analyzed. Results Univariate analysis showed that cervical lymph node metastasis was associated with male gender, age <55 years old, tumor diameter >5 mm, multiple foci,ETE and bilateral cancer (all P<0.05). Further analysis showed that central lymph node metastasis was most likely to occur in patients with male gender, age <55 years old, tumor diameter >5 mm, multiple foci, ETE, bilateral cancer (all P<0.05). Male patients with multiple foci, ETE and bilateral cancer were prone to lateral lymph node metastasis (all P<0.05). Logistic regression analysis showed that male gender, age <55 years old, tumor diameter >5 mm, multiple foci and ETE were independent risk factors for both cervical lymph node metastasis (all P<0.05) and central lymph node metastasis (all P<0.05). However, the independent risk factors for lateral lymph node metastasis were male gender, multiple foci and ETE (all P<0.05). Conclusions In PTMC patients with risk factors for lymph node metastasis such as male gender, age <55 years old, tumor diameter >5 mm, multifoci and ETE, preventive dissection of central lymph node should be routinely performed, and selective lateral lymph node dissection should be considered in combination with preoperative cervical B ultrasonography or enhanced computed tomography to reduce the risk of recurrence.Periodic B ultrasound thyroid examination and close follow-up are recommended for other PTMC patients.