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. 2025 Dec;57(1):2444551.
doi: 10.1080/07853890.2024.2444551. Epub 2024 Dec 20.

The clinical value of Delphian and pre-tracheal lymph nodes in predicting lateral lymph nodes metastasis of papillary thyroid carcinoma

Chun Huang  1 , Jing Zhou  2 , Yuchen Zhuang  2 , Tao Xu  1 , Xinliang Su  1
Affiliations

The clinical value of Delphian and pre-tracheal lymph nodes in predicting lateral lymph nodes metastasis of papillary thyroid carcinoma

Chun Huang et al. Ann Med. 2025 Dec.

Abstract

Background: Occult lymph node metastasis of papillary thyroid carcinoma is common. However, whether undergoing prophylactic lateral lymph node dissections is still controversial. This cross-sectional study with large cohort of patients aims to investigate the clinical value of Delphian and pre-tracheal lymph node in predicting lateral lymph node metastasis of papillary thyroid carcinoma.

Materials and methods: A retrospective analysis was conducted on 865 papillary thyroid carcinoma patients with Delphian and pre-tracheal lymph node data who underwent thyroidectomy plus central and lateral lymph node dissection. Data on clinicopathological characteristics were collected. Subsequently, a predictive model was established based on the results of the univariate and multivariate analyses.

Results: The rates of Delphian and pre-tracheal lymph node metastasis and lateral lymph node metastasis were 54.7% and 39.1%, respectively. Having ≥ 3 or 1-2 Delphian and pre-tracheal lymph node metastasis dramatically increased the risk of lateral lymph node metastasis (OR = 8.5, 95% CI 5.3-13.4 and OR = 3.9, 95% CI 2.7-5.7, respectively). The upper tumour had a 3.7 times higher risk of lateral lymph node metastasis than other locations. Patients ≤ 42 years or tumour size >8 mm had a higher risk of lateral lymph node metastasis.

Conclusions: Delphian and pre-tracheal lymph node metastasis was associated positively with the risk of lateral lymph node metastasis. For patients without clinical lateral lymph node metastasis, the Delphian and pre-tracheal lymph node could be considered to harvest as the first step in a thyroidectomy to facilitate further conduct of the operation.

Keywords: Delphian and pre-tracheal lymph node; lateral lymph node metastasis; lymph node dissection; papillary thyroid carcinoma.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Papillary thyroid carcinoma patients exclusion flowchart.
Figure 2.
Figure 2.
Forest plots of risk factors for lateral lymph node metastasis.
Figure 3.
Figure 3.
Nomogram for prediction of lateral lymph node metastasis.
Figure 4.
Figure 4.
ROC curves of the logistic regression model.
See this image and copyright information in PMC

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