Department of Otolaryngology Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Otolaryngology Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Laryngoscope. 2021 Sep;131(9):1990-1996. doi: 10.1002/lary.29426. Epub 2021 Jan 25.
OBJECTIVE/HYPOTHESIS: To evaluate the diagnostic accuracy of Delphian lymph node (DLN) metastasis for the prediction of central lymph node (CLN) metastasis and lateral lymph node (LLN) metastasis.
Two authors independently reviewed the six databases (Cochrane database, Embase, Google Scholar, PubMed, SCOPUS, and Web of Science). Four parameters were extracted from each study: true positive, true negative, false positive, and false negative. The quality of the methodology was evaluated using the Quality Assessment of Diagnostic Accuracy Studies ver. 2 tool.
The diagnostic odds ratio of DLN in CLN metastasis was 8.859 (95% confidence interval [CI], 4.419; 16.578). The area under the summary receiver operating characteristic curve was 0.748. The diagnostic odds ratio of DLN in LLN metastasis was 7.61 (95% CI, 4.48; 12.94). The area under the summary receiver operating characteristic curve was 0.837. DLN metastasis was moderately predictive of CLN metastasis (sensitivity = 32%, specificity = 95%), LLN metastasis (sensitivity = 52%, specificity = 89%), and contralateral CLN metastasis (sensitivity = 46%, specificity = 85%). DLN metastasis had statistically significant correlation with specific clinicopathological characteristics, including younger age (< 45 years old), bilaterality, capsule invasion, extrathyroidal extension, lymphovascular invasion, male sex, multifocality, and tumor size (> 1 cm).
The higher specificities of DLN pathology may help predict central and lateral compartment involvement in patients with thyroid cancer.
NA Laryngoscope, 131:1990-1996, 2021.
目的/假设：评估 Delphian 淋巴结 (DLN) 转移对中央淋巴结 (CLN) 转移和侧方淋巴结 (LLN) 转移预测的诊断准确性。
两位作者独立检索了六个数据库（Cochrane 数据库、Embase、Google Scholar、PubMed、SCOPUS 和 Web of Science）。从每项研究中提取了四个参数：真阳性、真阴性、假阳性和假阴性。使用诊断准确性研究质量评估工具（第 2 版）评估方法学的质量。
DLN 对 CLN 转移的诊断优势比为 8.859（95%置信区间 [CI]，4.419；16.578）。汇总受试者工作特征曲线下面积为 0.748。DLN 对 LLN 转移的诊断优势比为 7.61（95% CI，4.48；12.94）。汇总受试者工作特征曲线下面积为 0.837。DLN 转移对 CLN 转移（敏感性为 32%，特异性为 95%）、LLN 转移（敏感性为 52%，特异性为 89%）和对侧 CLN 转移（敏感性为 46%，特异性为 85%）具有中度预测价值。DLN 转移与特定的临床病理特征具有统计学显著相关性，包括年龄较小（<45 岁）、双侧性、包膜侵犯、甲状腺外延伸、淋巴血管侵犯、男性、多灶性和肿瘤大小较大（>1cm）。
DLN 病理学的更高特异性可能有助于预测甲状腺癌患者中央和侧方隔室的受累情况。
无。Laryngoscope, 131:1990-1996, 2021.
