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2000
Volume 21, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
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Abstract

Background

Delphian lymph node (DLN) metastasis is common in papillary thyroid cancer (PTC). However, few studies have specifically investigated the clinicopathologic characteristics of DLN metastasis in PTC. This study aimed to examine the incidence, risk factors, and predictive value of DLN in papillary thyroid carcinoma.

Methods

In the present study, the clinicopathologic features and metastatic risks were statistically analyzed by reviewing 1837 patients with papillary thyroid carcinoma who underwent initial surgery in our department between January, 2022 and July, 2024.

Results

Among the 1837 patients included in the study, DLN was detected in 925 patients (50.3%), of which 409 patients (22.3%) had confirmed DLN metastasis. In univariate analysis, DLN metastasis was correlated with age (≥55 years), bilateral cancer, multifocality, tumor location (isthmus cancer), central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM). However, it was not correlated with gender distribution, tumor size, thyroiditis, thyroid-stimulating hormone (TSH) level, and BRAF mutation. Multivariate analysis showed that CLNM (p=0.03), LLNM (p=0.025), bilateral cancer, and tumor location (p=0.012) were independent risk factors for DLN metastasis. DLN involvement was mildly predictive of CLNM (sensitivity=29.76%, specificity=87.06%, positive predictive values=74.08%, negative predictive values=49. 93%, positive likelihood ratio=2.30, negative likelihood ratio=0.81) and moderately predictive of LLNM (sensitivity=49.36%, specificity=85.01%, positive predictive values=46.94%, negative predictive values=86.20%, positive likelihood ratio=3.29, negative likelihood ratio=0.60).

Conclusion

Bilateral cancer, CLNM, LLNM, and isthmus cancer were independent risk factors for DLN metastasis. DLN metastasis could be used as a predictor for central and lateral lymph node metastasis. Positive DLN should be a warning signal to carefully evaluate central and lateral lymph nodes during thyroidectomy.

© 2025 The Author(s). Published by Bentham Science Publisher.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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2025-03-13
2025-12-27

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Significance and Predictive Value of Delphian Lymph Node in Papillary Thyroid Carcinoma
Curr. Med. Imaging 21, E15734056360214 (2025); https://doi.org/10.2174/0115734056360214250215155608
/content/journals/cmir/10.2174/0115734056360214250215155608
/content/journals/cmir/10.2174/0115734056360214250215155608
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  • Article Type:     Research Article
Keyword(s): Delphian lymph node; lateral lymph node; lymph node metastasis; papillary thyroid carcinoma; predictive value

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