Analysis of the Clinical Value of Delphian Lymph Node Metastasis in Papillary Thyroid Carcinoma

Abstract

Purpose. Delphian lymph node (DLN) is often involved in metastasis of malignant head and neck tumors. This study evaluates the predictive utility of the DLN and the clinicopathological factors related to DLN metastasis in individuals suffering from papillary thyroid carcinoma (PTC). Patients and Methods. A retrospective analysis was made on 969 PTC patients enrolled from 2017 to 2021. Among these patients, 522 PTC patients are DLN positive and 447 are negative. Comparisons of clinicopathological characteristics between the DLN-positive and DLN-negative patients were made. Results. The DLN was detected in 53.9% (522/969) cases, and DLN metastasis occurred in 20.3% (106/522) cases. The independent predictors of DLN metastasis (DLNM) include tumor size >1 cm, tumor located in the upper third thyroid or isthmus, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM). DLN-positive individuals exhibited a higher incidence and the number of CLNM, contralateral CLNM (CCLNM), and LLNM as compared to DLN-negative patients. Whether it is cN0 or cN+, the CLNM incidence was increased among DLN-positive patients as compared to that of DLN-negative patients. Conclusions. Positive DLN indicated an increased rate and number of metastases in the cervical lymph nodes. Intraoperative rapid freezing is recommended to assess the status of the DLN, and careful assessment of cervical lymph nodes is warranted when the DLN is involved to implement an appropriate surgical approach.

Nomogram for predicting the risk of central lymph node metastasis in papillary thyroid microcarcinoma: a combination of sonographic findings and clinical factors

“…This ratio provides important clues about the morphology of the nodule, which in turn helps to determine its malignancy ( 22 , 54 ). Assessing the fatty hilum is a more intuitive means to determining the CLNM risk than are other US characteristics ( 55 - 60 ). However, due to the limitations of US susceptibility to interference and reliance on the skill of the practitioner, we had only 80 cases across 2 sets in which loss of fat hilum was present, accounting for 7.7% of the total cases.…”