Choi et al. found that increased lymphatic vessel density, as assessed by high PDPN and VEGFR3 expression, was significantly associated with the incidence of lymph node metastasis in the papillary thyroid cancer context.220 Additionally, recurrent papillary thyroid cancer exhibited higher peritumoral lymphatic vessel density than nonrecurrent thyroid cancer.221 Moreover, lncRNA MFSD4A-AS1 functioned as a competing endogenous RNA to disrupt miRNA-mediated VEGFA/C repression and activated TGFβ signaling, thereby promoting lymphangiogenesis.222. This evidence concerns the gene FLT4 and metastatic malignant neoplasm in the lymph nodes.