A nomogram for individualized prediction for cervical lymph node metastasis of papillary thyroid carcinoma

Background: Cervical lymph node metastasis in papillary thyroid carcinoma plays a crucial role in the development of surgical strategy for thyroid patients. The aim of this study was to determine the predictors of cervical lymph node metastasis based on ultrasound features of papillary thyroid carcinoma, and to develop and validate nomogram to help predict cervical lymph node metastasis. Methods: Patients who underwent thyroid ultrasound examination in Department of Ultrasonography of The First Affiliated Hospital of Nanjing Medical University between January 1, 2021 and October 31, 2021 were selected. Patients with at least one Thyroid Imaging Reporting and Data System (TI-RADS) class 4 or higher nodule and postoperative pathologically confirmed primary papillary thyroid carcinoma with cervical lymph node metastasis were identified or not, and ultrasound image characteristics of the nodules were recorded to screen for cervical lymph node metastasis predictors. Subsequently, nomogram was developed and validated to help predict cervical lymph node metastasis. Results: The overall echogenicity of the thyroid gland, the number of malignant nodules, nodule left-right diameter, the location of the nodules, the relationship between the nodules and the thyroid capsule, and the elasticity score of the nodules were considered to be independent predictors of papillary thyroid carcinoma related cervical lymph node metastasis; the model had a good discrimination rate. Conclusions: We developed a nomogram to predict metastasis in the neck lymph nodes of papillary thyroid carcinoma, and the nomogram showed good performance for prediction aspects.