Risk factors and prediction models of lymph node metastasis in papillary thyroid carcinoma based on clinical and imaging characteristics

被引：4

作者：

Deng, Yuanyuan ^{[1
,2
,3
]}

Zhang, Jie ^{[1
,2
,3
]}

Wang, Jiao ^{[1
,2
,3
]}

Wang, Jinying ^{[1
,2
,3
]}

Zhang, Junping ^{[1
,2
,3
]}

Guan, Lulu ^{[1
,2
,3
]}

He, Shasha ^{[1
,2
,3
]}

Han, Xiudan ^{[1
,2
,3
]}

Cai, Wei ^{[4
]}

Xu, Jixiong ^{[1
,2
,3
]}

机构：

[1] Nanchang Univ, Dept Endocrinol & Metab, Affiliated Hosp 1, 17 Yongwaizheng St, Nanchang 330006, Jiangxi, Peoples R China

[2] Jiangxi Clin Res Ctr Endocrine & Metab Dis, Nanchang, Jiangxi, Peoples R China

[3] Natl Clin Res Ctr Metab Dis, Jiangxi Branch, Nanchang, Jiangxi, Peoples R China

[4] Nanchang Univ, Dept Med Genet & Cell Biol, Med Coll, Nanchang, Jiangxi, Peoples R China

来源：

POSTGRADUATE MEDICINE | 2023年 / 135卷 / 02期

关键词：

Papillary thyroid carcinoma; lymph node metastasis; prediction model; nomogram; CANCER; FEATURES; NODULES; MANAGEMENT; DIAGNOSIS; NOMOGRAM; YOUNGER; NUMBER; RATIO; PLR;

D O I：

10.1080/00325481.2022.2135840

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Papillary thyroid carcinoma (PTC) commonly presents with lymph node metastasis, which may be associated with worsened prognosis. This study aimed to comprehensively evaluate the risk factors of lymph node metastasis in PTC based on preoperative clinical and imaging data and to construct a nomogram model to predict the risk of lymph node metastasis. Methods A total of 989 patients with PTC were enrolled and randomly divided into training and validation cohorts in an 8:2 ratio. Independent risk factors for lymph node metastasis in PTC were analyzed using univariate and stepwise multivariate logistic regression. An importance analysis of independent risk factors affecting lymph node metastasis was performed according to the random forest method. Subsequently, a nomogram to predict lymph node metastasis was constructed, and the predictive effect of the nomogram was evaluated using receiver operating characteristic analysis and calibration curves. Results Univariate regression analysis revealed that age, sex, body weight, systolic blood pressure, free triiodothyronine, nodule location, nodule number, Thyroid Imaging Reporting and Data System (TI-RADS) grade on color Doppler ultrasound, enlarged lymph node present on imaging, and nodule diameter could affect lymph node metastasis in PTC. Stepwise multivariate regression analysis showed that sex, age, enlarged lymph node present on imaging, nodule diameter, and color Doppler TI-RADS grade were independent risk factors for lymph node metastasis in PTC. Combining these five independent risk factors, a nomogram prediction model was constructed. The area under the curve (AUC) of the nomogram in the training and validation cohorts was 0.742 and 0.765, respectively, with a well-fitted calibration curve. Conclusion Our study showed that independent risk factors for lymph node metastasis in PTC were sex, age, enlarged lymph node present on imaging, nodule diameter, and color Doppler TI-RADS grade. The nomogram constructed based on these independent risk factors can better predict the risk of lymph node metastasis.

引用

页码：121 / 127

页数：7

共 45 条

[1] Presence and Number of Lymph Node Metastases Are Associated With Compromised Survival for Patients Younger Than Age 45 Years With Papillary Thyroid Cancer [J].