| Summary: | Purpose: To explore the risk factors that may predict the lymph node metastasis potential of these lesions and new prevention strategies in papillary thyroid carcinoma patients.Materials and Methods: In total, 9,369 papillary thyroid carcinoma patients with 37.17% lymph node metastasis were analyzed (Revman 5.3 software) in this study. The PubMed and Embase databases were used for searching works systematically that were published through to January 22, 2020.Results: Several factors were related to the increased risk of lymph node metastasis in patients with papillary thyroid carcinoma: age <45 years (pooled OR = 1.52, 95% CI = 1.14–2.01, p <0.00001); gender = male (pooled OR = 1.68, 95% CI = 1.51–1.87, p <0.00001); multifocality (pooled OR = 2.05, 95% CI = 1.45–2.89, p <0.0001); tumor size ≥1.0 cm (pooled OR = 3.53, 95% CI = 2.62–4.76, p <0.00001); tumor location at the upper pole 1/3 (pooled OR =1.46, 95% CI = 1.04–2.04, p = 0.03); capsular invasion + (pooled OR = 3.48, 95% CI = 1.69–7.54, p = 0.002); and extrathyroidal extension + (pooled OR = 2.03, 95% CI= 1.78–2.31, p <0.00001). However, tumor bilaterality (pooled OR = 0.85, 95% CI = 0.54–1.34, p = 0.49) and Hashimoto's thyroditis (pooled OR = 1.08, 95% CI = 0.79–1.49, p = 0.62) showed no correlation with lymph node metastasis in papillary thyroid carcinoma patients.Conclusion: The systematic review and meta-analysis defined several significant risk factors of lymph node metastasis in papillary thyroid cancer patients: age (<45 years), gender (male), multifocality, tumor size (>1 cm), tumor location (1/3 upper), capsular invasion, and extra thyroidal extension. Bilateral tumors and Hashimoto's thyroiditis were unrelated to lymph node metastasis in patients with papillary thyroid cancer.
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