Research on Influence Factors and Clinical Significance of Delphian Lymph Node Metastasis in Papillary Thyroid Carcinoma

摘要

Objective To determine the incidence and significance of delphian lymph node metastasis in papillary thyroid cancer(PTC) and evaluate the clinical significance of delphian lymphnode metastasis in PTC patients. Methods We reviewed the medical records of 182 patients with pathologically confirmed PTC who underwent thyroid surgery and were detected delphian lymph nodes between September 2013 and January 2015 in the First Hospital of Jilin University. The relationship between related clinical factors and delphian lymph node metastasis was analyzed. The statistical significance of clinical factors were analyzed by logistic regression analysis, and were to further validate effect. Correlation analysis was carried between positive delphian lymph nodes and central paratracheal and lateral lymph nodes metastasis, the relationship between delphian lymph node metastasis and ipsilateral or contralateral VI region lymph node metastasis was analyzed. Results Delphian lymph node metastasis was related with factors of age, maximum diameter of tumor, capsule invasion, concomitant with Hashimoto's thyroiditis. Tumor larger than 1 cm and capsule invasion were the risk factors of delphian lymph node metastasis. Central and lateral lymph node metastasis rates were positive related with the number of metastatic delphian lymph nodes. When tumor was located in one side and with metastatic delphian lymph nodes, the metastasis rates of ipsilateral and contralateral VI region were higher. Conclusion Special attention should be paid on evaluation of delphian lymph nodes and intraoperative exploration. We should determine whether there are metastatic delphian lymph nodes before operationwhen patients have relevant risk factors. Patients with unilateral carcinoma whose delphian lymph nodes determined to be positive should expand the dissection of contralateral lymph node appropriately.