探讨cN0期单发病灶的甲状腺乳头状癌（PTC）CT征象及BRAF^V600E基因突变与中央区淋巴结转移（CLNM）的相关性。

收集2021年1月至2022年5月经病理确诊为PTC并行预防性中央区淋巴结清扫术的128例患者临床资料，根据中央区淋巴结有无转移分成转移组（n=50）和非转移组（n=78）。采用SPSS 16.0分析软件处理数据，通过单因素分析CT征象（瘤体与甲状腺边缘接触）、BRAF^V600E基因突变等与PTC患者CLNM的关系；多因素Logistic回归分析CLNM的影响因素。P<0.05为差异有统计学意义。

单因素分析结果显示：两组患者在年龄、性别、肿瘤最大径、是否合并桥本氏甲状腺炎、CT征象、BRAF^V600E基因相比，统计学差异有意义（P<0.05）；多因素回归分析显示：肿瘤最大径≥0.7 cm、合并桥本氏甲状腺炎、CT征象、BRAF^V600E基因突变为CLNM的独立危险因素（P<0.05）。

CT征象中瘤体与甲状腺边缘接触、BRAF^V600E基因突变、合并桥本氏甲状腺炎、肿瘤直径≥0.7 cm的cN0期单发病灶的PTC患者更易发生颈部中央区淋巴结转移，对于此类患者应术中预防性行中央区淋巴结清扫。

To investigate the correlation between CT signs, BRAF^V600E gene mutation and central lymph node metastasis (CLNM) in single focal thyroid papillary carcinoma (PTC) of cN0 stage.

Clinical data of 128 patients with pathological diagnosis of PTC and preventive central lymph node dissection from January 2021 to May 2022 were collected, and they were divided into metastatic group (n=50) and non-metastatic group (n=78) according to the presence or absence of central lymph node metastasis. SPSS 16.0 analysis software was used to analyze the relationship between CT signs (tumor and thyroid border contact), BRAFv600E gene mutation and CLNM in PTC patients by single factor analysis. The influencing factors of CLNM were analyzed by multivariate Logistic regression. P<0.05 was considered statistically significant.

Univariate analysis showed that there were significant differences in age, sex, maximum tumor diameter, Hashimoto's thyroiditis, CT signs and BRAF^V600E gene between the two groups (P<0.05). Multivariate regression analysis showed that maximum tumor diameter ≥0.7 cm, Hashimoto's thyroiditis, CT signs and BRAF^V600E gene mutation were independent risk factors for CLNM (P<0.05).

CT findings show that PTC patients with tumor and thyroid border contact, BRAF^V600E gene mutation, Hashimoto's thyroiditis, and cN0 stage single lesions with tumor diameter ≥0.7 cm are more likely to develop central cervical lymph node metastasis, and intraoperative preventive central lymph node dissection should be performed for these patients.