Clinical significance of Delphian lymph node metastasis in regional lymph node involvement of intrathyroidal papillary thyroid carcinoma
10.3760/cma.j.cn113855-20250306-00121
- VernacularTitle:喉前淋巴结转移在腺内型甲状腺乳头状癌各区淋巴结转移中的价值
- Author:
Haijie HUANG
1
;
Guofa WU
;
Lanlan XIE
;
Shitu CHEN
;
Zhendong CHEN
;
Xinguang JIN
;
Weibin WANG
Author Information
1. 海宁市人民医院普外二科，海宁 314400
- Publication Type:Journal Article
- Keywords:
Thyroid cancer, papillary;
Lymphatic metastasis
- From:
Chinese Journal of General Surgery
2025;40(10):762-768
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical value of Delphian lymph node (DLN) metastasis (DLNM) in predicting regional lymph node involvement in patients with intrathyroidal papillary thyroid carcinoma (PTC).Methods:Clinical and pathological data from 345 consecutive patients with pathologically confirmed DLN status, who underwent initial surgical treatment at the Department of Surgical Oncology, First Affiliated Hospital of Zhejiang University School of Medicine between Jan 2020 and Dec 2022, were retrospectively analyzed.Results:DLNM was identified in 61 patients (17.7%). Univariate analysis revealed significant associations between DLNM and male sex, elevated preoperative thyroglobulin levels, larger tumor size, maximum tumor diameter >10 mm, bilateral lesions, multifocality, lymphovascular invasion, and lymph nodes metastases in pretracheal, paratracheal, and lateral cervical(all P ≤0.001). Elevated thyroglobulin antibody levels ( χ2=6.201, P=0.013) and Hashimoto's thyroiditis ( χ2=11.340, P<0.001) were protective factors for DLNM. Multivariate analysis identified male sex, lymphovascular invasion, pretracheal, and paratracheal lymph node metastases ( χ2=6.689, P=0.010; χ2=8.163, P=0.004; χ2=7.605, P=0.006; χ2=8.324, P=0.004) as independent risk indicators for DLNM. Patients with DLNM exhibited significantly higher risks of lymph nodes metastases in pretracheal ( χ2=27.307, P<0.001), paratracheal ( χ2=38.697, P<0.001), and lateral cervical ( χ2=36.459, P<0.001). Conclusion:DLNM demonstrates predictive value for both central compartment and lateral cervical lymph node metastases, warranting particular attention to meticulous dissection of the prelaryngeal region during surgery.
