ObjectiveTo investigate the risk factors affecting on cervical central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) in patients with papillary thyroid carcinoma (PTC). MethodsThe patients with newly diagnosed with PTC who underwent surgical treatment in this hospital from April 2020 to December 2023 were included. The univariate and multivariate logistic regression analyses were conducted to identify the risk factors influencing the occurrences of CLNM and LLNM in patients with PTC and a prediction model was developed using these risk factors. Additionally,the discriminatory power of the predictive model for CLNM and LLNM was evaluated using the area under the receiver operating characteristic curve (AUC). ResultsA total of 297 patients with PTC were included in this study, among whom 149 (50.2%) cases developed CLNM, and 41 (13.8%) cases developed LLNM. The multivariate analysis indicated that the male, age <36 years old and maximum tumor diameter >5 mm were the independent risk factors for CLNM in the patients with PTC (P<0.05). The independent risk factors for LLNM in the patients with PTC were the age ≥59 years old, bilateral (or isthmus) cancer foci, maximum tumor diameter >5 mm, and invasion of the capsule (P<0.05). The AUC (95%CI) of the CLNM prediction model, constructed using three risk-associated factors (gender, age, and maximum tumor diameter), was 0.693 (0.633, 0.752). For the LLNM prediction model, which incorporated four factors [age, unilateral/bilateral (or isthmus), maximum tumor diameter, and capsular invasion], the AUC (95% CI) was 0.776 (0.707, 0.846).ConclusionsThe data indicate that PTC patients with maximum tumor diameter (>5 mm) and young (age <36 years old) male characteristics exhibite a higher risk of CLNM, patients with maximum tumor diameter (>5 mm), capsular invasion, bilateral (or isthmus) cancer foci, and elderly (age ≥59 years old) characteristics exhibite a higher risk of LLNM.