Abstract:Objective To analyze the associations of the clinical and pathological features with central lymph node metastasis in patients with papillary thyroid microcarcinoma (PTMC) to explore the risk factors of central lymph node metastasis and provide a theoretical basis for the surgical options in PTMC patients. Methods A total of 308 PTMC patients receiving prophylactic central lymph node dissection (CLND) in Nanjing Dram Tower Hospital from January 2014 to August 2016 were selected. Realtime fluorescence quantitative polymerase chain reaction (RT-PCR) was used to detect BRAFV600E (v-raf murine sarcoma viral oncogene homolog B1) gene mutation, and the associations of clinicopathological features and BRAFV600E mutation with central lymph node metastasis were analyzed retrospectively. Results The male patients less than 45 years old with larger tumor size (>5 mm), tumor multifocality, psammoma bodies, intraglandular dissemination and BRAFV600E gene mutation were more likely to have central lymph node metastasis (P<0.05). While the central lymph node metastasis was not significantly associated with thyroglobulin level and whether there were chronic lymphocytic thyroiditis, nodular goiter or adenoma, complete capsule, invasion of thyroid capsule, extrathyroid invasion, vascular invasion and neural invasion (P>0.05). Logistic regression analysis showed that male gender, younger age (<45 years dd), larger tumor size (>5 mm), multifocality, psammoma bodies, intraglandular dissemination and BRAFV600E gene mutation were the risk factors of central lymph node metastasis in PTMC patient. Conclusion It is suggested that the preventive central lymph node dissection should be performed for the patients with high risk factors of central lymph node metastasis.