Multivariate analysis reported that male gender (p= 0.041), age < 45 years (p= 0.042), preoperative calcitonin > 65 pg/ mL (p= 0.039), nodule size > 5 mm Ø (p= 0.038), bilaterality (p= 0.038), tumor capsular invasion (p= 0.048), cystic change (p= 0.047), and hyper vascularity (p= 0.049) of thyroid nodules were associated with lymph node metastasis (Table 5). This evidence concerns the gene CALCA and metastatic malignant neoplasm in the lymph nodes.