ObjectiveThe papillary thyroid cancer (PTC) incidence is on the increase. We explored the diagnostic value of microRNA (miR)-129-5p & serologic indicator thyroid-stimulating hormone (TSH) test in PTC with cervical lymph node metastasis (LNM).MethodsAccording to the pathological "gold standard," 198 PTC patients were assigned into the LNM (n = 93)/non-LNM (n = 105) groups, with their medical records collected. The serum free-triiodothyronine (FT3)/free-thyroxine (FT4)/TSH/thyroglobulin (Tg)/thyroglobulin antibody levels were assessed using an electrochemiluminescence immunoassay device. Serum miR-129-5p expression was determined by reverse transcription quantitative polymerase chain reaction. Correlations between serum miR-129-5p/TSH levels with pathological indicators were analyzed by Spearman correlation coefficient. Independent influencing factors for cervical LNM in PTC patients was analyzed by logistic multivariate regression analysis. Diagnostic value of miR-129-5p combined with serologic indicator TSH test in PTC patients with cervical LNM and lateral cervical LNM was analyzed by the receiver operating characteristic curve.ResultsThe two groups varied obviously in primary tumor size/Tg level. Serum miR-129-5p expression in the LNM group was reduced, and negatively correlated with Tg and primary tumor size, while the serologic indicator TSH level showed positive correlations with Tg and primary tumor size. Independent influencing factors for PTC with cervical LNM were miR-129-5p/TSH/Tg levels. miR-129-5p and serologic indicator TSH levels had high diagnostic value for PTC patients with cervical LNM and lateral cervical LNM, with their combination showing higher diagnostic value.ConclusionmiR-129-5p and serologic indicator TSH had high diagnostic value for diagnosing PTC patients with cervical LNM, providing high reference value for the formulation of thyroid tumor resection.