Risk factors for Delphian lymph node metastasis in papillary thyroid carcinoma

doi:10.16139/j.1007-9610.2022.05.014

Abstract

Abstract: Objective To investigate the risk factors for Delphian lymph node metastasis in papillary thyroid carcinoma. Methods Retrospective analysis of 99 patients treated in Taizhou Cancer Hospital from July 2017 to July 2019 were done in this study. Delphian lymph nodes metastasis related with tumor diameter, location or central lymph node metastasis were analyzed. Results The rate of detected Delphian lymph node in the patients with radical operation of papillary thyroid carcinoma was 70.7% (70/99) with the metastasis rate 18.6% (13/70). Totally 13 in 99 cases (13.1%) were found metastasis. Univariate analysis showed that Delphian lymph node metastasis was related with the number of lymph nodes detected (t=7.040, P=0.008), age (t=4.714, P=0.030), the foci located at isthmus (t=11.588, P=0.001), and pretracheal lymph node metastasis (t=8.659, P=0.003). There was no significant relationship between Delphian lymph node metastasis and gender, tumor diameter, multiple foci, bilateral lesions, extrathyroid invasion, or foci located in upper third of thyroid lobe (P>0.05). Multivariate Logistics analysis showed that isthmus carcinoma (P=0.010, OR=9.079), more than 2 Delphian lymph nodes (P=0.005, OR=18.739), and pretracheal lymph node metastasis (P=0.013, OR=8.530) were independent risk factors of Delphian lymph node metastasis. Conclusions It should be paid more attention to Delphian lymph node during central department lymph node dissection for those patients with thyroid isthmus carcinoma, pretracheal lymph node metastasis and many lymph nodes.

Key words: Papillary thyroid carcinoma, Delphian lymph node, Central lymph node dissection

CLC Number:

R736.1

YAN Haibo, XIA Zhongping, CHEN Shan, JIANG Lin, HAN Chun. Risk factors for Delphian lymph node metastasis in papillary thyroid carcinoma[J]. Journal of Surgery Concepts & Practice, 2022, 27(05): 453-457.

Figures/Tables 3

References 26

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项目	DLN结转移		t值	P值
项目	有（n=13）	无（n=86）	t值	P值
年龄（岁） ≥55 <55	1（2.9%） 12（18.5%）	33（97.1%） 53（81.5%）	4.714	0.030
性别女男	9（11.8%） 4（17.4%）	67（88.2%） 19（82.6%）	0.477	0.490
肿瘤直径（cm） ≤1.0 >1.0	6（8.8%） 7（22.6%）	62（91.2%） 24（77.4%）	3.533	0.060
多灶癌是否	6（19.4%） 7（10.3%）	25（80.6%） 61（89.7%）	1.532	0.216
双侧癌是否	2（11.1%） 11（13.6%）	16（88.9%） 70（86.4%）	0.079	0.779
癌灶位于峡部是否	7（36.8%） 6（7.5%）	12（63.2%） 74（92.5%）	11.588	0.001
包膜外侵犯是否	2（22.2%） 11（12.2%）	7（77.8%） 79（88.8%）	0.719	0.397
癌灶位于上极中、下部	3（9.7%） 10（14.7%）	28（90.3%） 58（85.3%）	0.472	0.492
DLN检出数（枚） ≤2 >2	9（10.1%） 4（40.0%）	80（89.9%） 6（60.0%）	7.040	0.008
气管前淋巴结转移是否	7（31.8%） 6（7.8%）	15（68.2%） 71（92.2%）	8.659	0.003

项目	P值	OR	95% CI
年龄<55岁	0.072	0.113	0.011~1.211
癌灶位于峡部	0.010	9.079	1.702~48.429
DLN检出>2（枚）	0.005	18.739	2.382~147.402
气管前淋巴结转移	0.013	8.530	1.559~46.672