Research On Influence Factors And Clinical Significance Of Delphian Lymph Node Metastasis In Papillary Thyroid Carcinoma

Objective: The objective of this study was to determine the incidenceand significance of delphian lymph node metastasis in papillary thyroidcancer and to evaluate the clinical significance of delphian lymph nodemetastasis in patients with papillary thyroid cancer.Methods: This paper reviewed the medical records of182patients withpathologically confirmed papillary thyroid carcinoma who underwentthyroid surgery and was detected delphian lymph node betweenSeptember2013and January2015in the No.1Hospital of JilinUniversity. The relationship between related clinical factors and thedelphian lymph node metastasis is analyzed, such as sex, age, biggestdiameter of tumor, multicentricity, capsule invasion, concomitantHashimoto’s thyroiditis, concomitant nodular goiter, concomitantthyroid adenoma, central metastasis and lateral metastasis. The clinicalfactors of statistical significance were analyzed by logistic regressionanalysis, and were to further validate effect. Correlation analysis wascarried between positive number of delphian lymph node and centralparatracheal lymph node and lateral metastasis, the relationship betweendelphian lymph node metastasis and ipsilateral or contralateral LevelⅥ lymph node metastasis. Results: The difference was statistically significant in the study ofdelphian lymph node metastasis and age（P=0.005）、biggest diameter oftumor（P＜0.001）、capsule invasion（P=0.003）and concomitantHashimoto’s thyroiditis（P=0.015）, there was no significant differencewith other clinical features. Multivariate logistic regression analysisshowed that biggest diameter of tumor＞1cm and capsule invasionP-value respectively to be＜0.001、0.038，OR4.895、2.563，95%CIfor EXP2.401~9.981、1.055~6.226；The central paratracheal lymphnode metastasis rate and the number of delphian lymph node metastasisKendall correlation coefficient and Spearman correlation coefficientwas1, P <0.01, lateral cervical lymph node metastasis rate and thenumber of delphian lymph node metastasis Kendall correlationcoefficient is0.714, the Spearman correlation coefficient was0.739,P<0.01; positive lymph nodes with delphian the transfer rate is higherand the contralateral level Ⅵ lymph node (P <0.05).Conclusion: Delphian lymph node metastasis is related with the factorsof age, biggest diameter of tumor, capsule invasion, concomitantHashimoto’s thyroiditis. Tumor size larger than1cm and capsuleinvasion are the danger factors of delphian lymph node metastasis.When delphian lymph node metastasis is detected, patients were3.0times more likely to have further central compartment metastasis and1.5times to have lateral compartment metastasis. And metastasis rate are positive related with the number of metastatic delphian lymph node.When patients are with single side involved and metastatic delphianlymph node, the metastasis rate of affected side and opponent Level Ⅵis higher.