Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Current Medical Imaging
  4. Fast Track Articles
  5. Fast Track Article
image of Significance and Predictive Value of Delphian Lymph Node in Papillary Thyroid Carcinoma
file format pdf download PDF

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 © 2025 The Author(s). Published by Bentham Science Publisher. The Author(s)
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.
Loading

Article metrics loading...

/content/journals/cmir/10.2174/0115734056360214250215155608
2025-03-13
2025-04-02

  • From This Site

    /content/journals/cmir/10.2174/0115734056360214250215155608
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
The full text of this item is not currently available.

References

  1. Li X. Li E. Du J. Wang J. Zheng B. BRAF mutation analysis by ARMS‐PCR refines thyroid nodule management. Clin. Endocrinol. 2019 91 6 834 841 10.1111/cen.14079 31441082
    [Google Scholar]
  2. Kim D.H. Kim G.J. Kim S.W. Hwang S.H. Predictive value of ipsilateral central lymph node metastasis for contralateral central lymph node metastasis in patients with thyroid cancer: Systematic review and meta‐analysis. Head Neck 2021 43 10 3177 3184 10.1002/hed.26787 34124791
    [Google Scholar]
  3. Wang B. Wen X. Zhang W. Qiu M. Clinical implications of Delphian lymph node metastasis in papillary thyroid carcinoma: A single-institution study, systemic review and meta-analysis. J. Otolaryngol. Head Neck Surg. 2019 48 1 42 10.1186/s40463‑019‑0362‑7 31470907
    [Google Scholar]
  4. Isaacs J.D. Lundgren C.I. Sidhu S.B. Sywak M.S. Edhouse P.J. Delbridge L.W. The Delphian lymph node in thyroid cancer. Ann. Surg. 2008 247 3 477 482 10.1097/SLA.0b013e31815efdc4 18376193
    [Google Scholar]
  5. Yan Y. Wang Y. Liu N. Duan Y. Chen X. Ye B. Yang R. Zhang W. Wang X. Predictive value of the Delphian lymph node in cervical lymph node metastasis of papillary thyroid carcinoma. Eur. J. Surg. Oncol. 2021 47 7 1727 1733 10.1016/j.ejso.2021.02.010 33632590
    [Google Scholar]
  6. Isaacs J.D. McMullen T.P.W. Sidhu S.B. Sywak M.S. Robinson B.G. Delbridge L.W. Predictive value of the Delphian and level VI nodes in papillary thyroid cancer. ANZ J. Surg. 2010 80 11 834 838 10.1111/j.1445‑2197.2010.05334.x 20969694
    [Google Scholar]
  7. Zhao H. Huang T. Li H. Risk factors for skip metastasis and lateral lymph node metastasis of papillary thyroid cancer. Surgery 2019 166 1 55 60 10.1016/j.surg.2019.01.025 30876667
    [Google Scholar]
  8. Lee Y.C. Shin S.Y. Kwon K.H. Eun Y.G. Incidence and clinical characteristics of prelaryngeal lymph node metastasis in papillary thyroid cancer. Eur. Arch. Otorhinolaryngol. 2013 270 9 2547 2550 10.1007/s00405‑013‑2471‑7 23553243
    [Google Scholar]
  9. Nakayama M. Seino Y. Okamoto M. Mikami T. Okamoto T. Miyamoto S. Clinical significance of positive Delphian node in supracricoid laryngectomy with cricohyoidoepiglottopexy. Jpn. J. Clin. Oncol. 2011 41 8 987 991 10.1093/jjco/hyr091 21715365
    [Google Scholar]
  10. Pignataro L. Peri A. Pagani D. Scaramellini G. Broich G. Prognostic value of Delphian lymph node in T1b glottic carcinoma. Anticancer Res. 2003 23 3C 2961 2963 12926144
    [Google Scholar]
  11. Wierzbicka M. Leszczyńska M. Młodkowska A. Szyfter W. Bartochowska A. The impact of prelaryngeal node metastases on early glottic cancer treatment results. Eur. Arch. Otorhinolaryngol. 2012 269 1 193 199 10.1007/s00405‑011‑1747‑z 21898087
    [Google Scholar]
  12. Lee Y.C. Na S.Y. Chung H. Kim S.I. Eun Y.G. Clinicopathologic characteristics and pattern of central lymph node metastasis in papillary thyroid cancer located in the isthmus. Laryngoscope 2016 126 10 2419 2421 10.1002/lary.25926 27098428
    [Google Scholar]
  13. Iyer N.G. Kumar A. Nixon I.J. Patel S.G. Ganly I. Tuttle R.M. Shah J.P. Shaha A.R. Incidence and significance of Delphian node metastasis in papillary thyroid cancer. Ann. Surg. 2011 253 5 988 991 10.1097/SLA.0b013e31821219ca 21372688
    [Google Scholar]
  14. Tan Z. Ge M.H. Zheng C.M. Wang Q.L. Nie X.L. Jiang L.H. The significance of Delphian lymph node in papillary thyroid cancer. Asia Pac. J. Clin. Oncol. 2017 13 5 e389 e393 10.1111/ajco.12480 26990889
    [Google Scholar]
  15. Kim W.W. Yang S.I. Kim J.H. Choi Y.S. Park Y.H. Kwon S.K. Experience and analysis of Delphian lymph node metastasis in patients with papillary thyroid carcinoma. World J. Surg. Oncol. 2012 10 1 226 10.1186/1477‑7819‑10‑226 23110552
    [Google Scholar]
  16. Chai Y.J. Kim S. Choi J.Y. Koo D.H. Lee K.E. Youn Y.K. Papillary thyroid carcinoma located in the isthmus or upper third is associated with Delphian lymph node metastasis. World J. Surg. 2014 38 6 1306 1311 10.1007/s00268‑013‑2406‑x 24366273
    [Google Scholar]
  17. Oh E.M. Chung Y.S. Lee Y.D. Clinical significance of Delphian lymph node metastasis in papillary thyroid carcinoma. World J. Surg. 2013 37 11 2594 2599 10.1007/s00268‑013‑2157‑8 23877804
    [Google Scholar]
  18. Gong J.X. Gu J.W. Ji F. Li K. Zhu Q. Gu F.Y. Chen Y. Ji Q.H. Clinical study on prelaryngeal lymph node metastasis in papillary thyroid carcinoma. Cancer Manag. Res. 2020 12 1323 1327 10.2147/CMAR.S232884 32110106
    [Google Scholar]
  19. Zhou L. Gao C. Li H. Liang W. Zeng Q. Chen B. Isthmic papillary thyroid carcinoma presents a unique pattern of central lymph node metastasis. Cancer Manag. Res. 2020 12 3643 3650 10.2147/CMAR.S252692 32547201
    [Google Scholar]
  20. Son Y.I. Jeong H.S. Baek C.H. Chung M.K. Ryu J. Chung J.H. So Y.K. Jang J.Y. Choi J. Extent of prophylactic lymph node dissection in the central neck area of the patients with papillary thyroid carcinoma: comparison of limited versus comprehensive lymph node dissection in a 2-year safety study. Ann. Surg. Oncol. 2008 15 7 2020 2026 10.1245/s10434‑008‑9928‑8 18459004
    [Google Scholar]
  21. Ji Y.B. Yoo H.S. Song C.M. Park C.W. Lee C.B. Tae K. Predictive factors and pattern of central lymph node metastasis in unilateral papillary thyroid carcinoma. Auris Nasus Larynx 2016 43 1 79 83 10.1016/j.anl.2015.09.005 26441368
    [Google Scholar]
  22. Zhou L. Li H. Liang W. Gao C. Chen B. Pretracheal–laryngeal lymph nodes in frozen section predicting contralateral paratracheal lymph nodes metastasis. Eur. J. Surg. Oncol. 2020 46 10 1829 1834 10.1016/j.ejso.2020.06.048 32792222
    [Google Scholar]
  23. Merdad M. Eskander A. Kroeker T. Freeman J.L. Metastatic papillary thyroid cancer with lateral neck disease: Pattern of spread by level. Head Neck 2013 35 10 1439 1442 10.1002/hed.23149 22965902
    [Google Scholar]
  24. Feng J.W. Qin A.C. Ye J. Pan H. Jiang Y. Qu Z. Predictive factors for lateral lymph node metastasis and skip metastasis in papillary thyroid carcinoma. Endocr. Pathol. 2020 31 1 67 76 10.1007/s12022‑019‑09599‑w 31828583
    [Google Scholar]
  25. Lee Y.S. Shin S.C. Lim Y.S. Lee J.C. Wang S.G. Son S.M. Kim I.J. Lee B.J. Tumor location-dependent skip lateral cervical lymph node metastasis in papillary thyroid cancer. Head Neck 2014 36 6 887 891 10.1002/hed.23391 23733708
    [Google Scholar]
/content/journals/cmir/10.2174/0115734056360214250215155608
Loading
Significance and Predictive Value of Delphian Lymph Node in Papillary Thyroid Carcinoma
Bentham Science Publishers , e15734056360214; https://doi.org/10.2174/0115734056360214250215155608
/content/journals/cmir/10.2174/0115734056360214250215155608
/content/journals/cmir/10.2174/0115734056360214250215155608
Loading

Data & Media loading...


  • Article Type:     Research Article
Keywords: lymph node metastasis ; lateral lymph node ; Delphian lymph node ; predictive value ; papillary thyroid carcinoma

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test