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.