Department of General Surgery, Changzheng Hospital, Second Military Medical University, No. 415 in Fengyang Road, Huangpu District, Shanghai, 200003, China.
J Otolaryngol Head Neck Surg. 2019 Aug 30;48(1):42. doi: 10.1186/s40463-019-0362-7.
To evaluate the possible predictive value and clinicopathological characteristics of Delphian lymph node metastasis in papillary thyroid carcinoma.
A retrospective analysis of papillary thyroid carcinoma patients with Delphian lymph node metastasis in a single institution and meta-analysis of literature reports were performed.
In own series, Delphian lymph node metastasis was detected in 19 (9.9%) of 192 papillary thyroid carcinoma patients and was significantly associated with tumor size≥1 cm (P = 0.003), multifocality (P = 0.006) and extrathyroid extension (P < 0.001) in the multivariate analysis. Female was a protective factor for Delphian lymph node metastasis (P = 0.001). Delphian lymph node metastasis was highly predictive of further central lymph node metastasis (positive predictive value = 89.5%, negative predictive value = 67.6%) and moderately predictive of lateral lymph node metastasis (positive predictive value = 26.3%, negative predictive value = 95.4%). In this meta-analysis, there was a strong correlation between Delphian lymph node metastasis and aggressive clinicopathologic characteristics with regards to multifocality (P = 0.0008), bilaterality (P = 0.04), extrathyroid extension (P < 0.00001), lymphovascular invasion (P < 0.00001), further central lymph node metastasis (P < 0.00001) and lateral lymph node metastasis (P < 0.00001).
This single-institution observational study and meta-analysis identified that Delphian lymph node metastasis was significantly associated with unfavorable clinicopathological characteristics and had a strong predictive power for further disease in the central compartment.
The clinical study was retrospectively registered to UMIN clinical trials registry (the registry number: UMIN000033835 ).
评估 Delphian 淋巴结转移在甲状腺乳头状癌中的潜在预测价值和临床病理特征。
对单中心甲状腺乳头状癌伴 Delphian 淋巴结转移患者进行回顾性分析，并进行文献报告的荟萃分析。
在本系列中，192 例甲状腺乳头状癌患者中有 19 例（9.9%）检测到 Delphian 淋巴结转移，多因素分析显示其与肿瘤大小≥1cm（P=0.003）、多灶性（P=0.006）和甲状腺外侵犯（P<0.001）显著相关。女性是 Delphian 淋巴结转移的保护因素（P=0.001）。Delphian 淋巴结转移对进一步中央淋巴结转移具有高度预测价值（阳性预测值=89.5%，阴性预测值=67.6%），对侧淋巴结转移具有中度预测价值（阳性预测值=26.3%，阴性预测值=95.4%）。在这项荟萃分析中，Delphian 淋巴结转移与多灶性（P=0.0008）、双侧性（P=0.04）、甲状腺外侵犯（P<0.00001）、血管淋巴管侵犯（P<0.00001）、进一步中央淋巴结转移（P<0.00001）和侧方淋巴结转移（P<0.00001）等侵袭性临床病理特征之间存在密切相关性。
这项单中心观察性研究和荟萃分析表明，Delphian 淋巴结转移与不良的临床病理特征显著相关，对中央区进一步疾病具有较强的预测能力。
该临床研究已在 UMIN 临床试验注册库（注册号：UMIN000033835）进行了回顾性注册。
