To investigate the clinical significance and predictive value of BRAF^V600E mutation for central lymph node metastasis (CLNM) in patients with cN0 papillary thyroid microcarcinoma (PTMC).

A retrospective analysis was performed in 222 patients with pathologically confirmed cN0 PTMC from January 2017 to January 2020. The correlation between BRAF^V600E mutation and CLNM of PTMC was analyzed. Statistical analysis was performed by using SPSS 23.0 software. The χ² test was used for univariate analysis and Logistic regression was used for multivariate analysis. A P value of < 0.05 were considered as statistically significant difference.

Among 222 patients, there were 94 cases (42.3%) of CLNM. Tumor size, multifocality, capsular invasion and BRAF^V600E mutation were independent risk factors for CLNM (P<0.05), however BRAF^V600E mutation (OR=2.445, 95% CI: 1.557~3.840) was the most important independent risk factor for CLNM.

PTMC patients had a high rate of CLNM, and prophylactic central lymph node clearance should be routinely performed in patients with BRAF^V600E mutation. BRAF^V600E mutation could effectively predict CLNM in patients with cN0 PTMC.