甲状腺乳头状癌 (PTC) 中经常观察到淋巴结转移 (LNM)，大多数临床指南建议进行甲状腺全切除术。然而，LNM 对特定类型局部区域复发的影响仍不确定，特别是对于 T1 期 PTC。本回顾性队列研究纳入了 2008 年至 2015 年间诊断为 T1 期 PTC 的患者。对伴有不同程度肺叶切除术的患者进行了倾向评分匹配。 LNM 度数。采用Logistic回归分析比较LNM对复发类型的影响，并采用Kaplan-Meier法计算无复发生存率。研究队列由2,785名患者组成，平均随访时间为69个月。在控制随访时间和潜在预后因素后，我们每组总共纳入 362 名患者。 N0、N1a 和 N1b 组的复发率分别为 2.5%、9.7% 和 10.2%。值得注意的是，N1a组与N0组（P=0.803）、N1b组与N0组（P=0.465）、N1b组与N1a组（P=0.344）在残余甲状腺复发方面没有差异。然而，当考虑淋巴结复发时，N1a（P=0.003）和N1b（P=0.009）组均比N0组表现出更高的风险。此外，N1b组和N1a组的淋巴结复发率没有差异（P=0.364），但淋巴结阳性率（PLN）和淋巴结阳性率（LNPR）表现出很强的区分作用（P<0.001）。可能更适合低 LNPR 组的单侧 T1 期 PTC 患者。版权所有 © 2024 秦、蔡、齐、刘、徐、尹、唐、吉、廖和王。

The presence of lymph node metastasis (LNM) is frequently observed in papillary thyroid carcinoma (PTC), and most clinical guidelines recommend total thyroidectomy. However, the impact of LNM on specific types of locoregional recurrence remains uncertain, particularly for stage T1 PTC.The present retrospective cohort study enrolled patients diagnosed with stage T1 PTC between 2008 and 2015. Propensity score matching was performed in patients with lobectomy accompanied by varying degrees of LNM. Logistic regression analysis was performed to compare the effect of LNM on relapse types, and Kaplan-Meier method was utilized to calculate recurrence-free survival.The study cohort comprised 2,785 patients who were followed up for an average duration of 69 months. After controlling follow-up time and potential prognostic factors, we include a total of 362 patients in each group. Recurrence rates in the N0, N1a, and N1b groups were found to be 2.5%, 9.7%, and 10.2% respectively. Notably, group N1a versus group N0 (P=0.803), N1b group versus N0 group (P=0.465), and group N1b versus group N1a (P=0.344) had no difference in residual thyroid recurrence. However, when considering lymph node recurrence, both N1a(P=0.003) and N1b(P=0.009) groups showed a higher risk than N0 group. In addition, there was no difference in lymph node recurrence between N1b group and N1a group (P=0.364), but positive lymph node (PLN) and lymph node positive rate (LNPR) demonstrated a strong discriminatory effect (P<0.001).Lobectomy may be more appropriate for patients with unilateral stage T1 PTC in the low LNPR group.Copyright © 2024 Qin, Cai, Qi, Liu, Xu, Yin, Tang, Ji, Liao and Wang.