Objective: To investigate the risk factors for lateral cervical lymph node metastasis in papillary thy-roid carcinoma

and to explore the clinical significance of intraoperative biopsy of lateral cervical lymph nodes.Methods: A total of 135 patients with papillary thyroid carcinoma underwent surgical treatment. The excised thyroidgland and lymph node specimens underwent intraoperative rapid frozen sectioning and were examined and diagnosedby two pathologists. Intraoperative biopsy of the suspicious lateral cervical lymph nodes was performed to determinewhether a standard modified lateral cervical lymph node dissection should be performed. The biopsied lymph nodeswere divided into two regions: region III and/or region IV. The clinical features of patients

the histopathological fea-tures of the primary tumor

and the status of lymph node metastasis were recorded

and the results were statisticallyanalyzed. Results: Thirty-seven（27.41%） of the patients had lateral cervical lymph node metastases according tothe biopsy results

of whom 23 patients（62.16%） had metastases in region III

8 patients（21.62%） in region IV

and 6 patients（16.22%） in both regions III and IV. Ninety-eight patients（72.59%） had negative biopsy results andrelatively large tumor sizes（ > 10 mm）. Patient age

involvement of the capsule

and the number of multiple lymphnode metastases in the central region（ > 3） were significantly associated with lateral cervical lymph node metastasis（P < 0.05）. Conclusion: For patients with relatively large tumors

involvement of the capsule

extraglandular inva-sion

and multiple lymph node metastases in the central region（ > 3）

intraoperative biopsy of cervical lymph nodesin regions III and IV has certain clinical significance.