Nomogram for preoperative estimation risk of lateral cervical lymph node metastasis in papillary thyroid carcinoma: a multicenter study

Cancer Imaging

Research Article

Jialin Zhu¹  Deyi Li¹  Xueqing Wei¹  Bing Yue¹  Luchen Chang¹  Xi Wei¹  Dai Li² 

[1] Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, 300060, Tianjin, China;Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Geriatrics Institute, Tianjin Medical University General Hospital, 300060, Tianjin, China;

关键词: Nomogram;    Lateral lymph node metastasis;    Papillary thyroid carcinoma;    Ultrasonography;   

DOI  :  10.1186/s40644-023-00568-5

 received in 2022-12-31, accepted in 2023-05-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLateral lymph node metastasis (LLNM) is frequent in papillary thyroid carcinoma (PTC) and is associated with a poor prognosis. This study aimed to developed a clinical-ultrasound (Clin-US) nomogram to predict LLNM in patients with PTC.MethodsIn total, 2612 PTC patients from two hospitals (H1: 1732 patients in the training cohort and 578 patients in the internal testing cohort; H2: 302 patients in the external testing cohort) were retrospectively enrolled. The associations between LLNM and preoperative clinical and sonographic characteristics were evaluated by the univariable and multivariable logistic regression analysis. The Clin-US nomogram was built basing on multivariate logistic regression analysis. The predicting performance of Clin-US nomogram was evaluated by calibration, discrimination and clinical usefulness.ResultsThe age, gender, maximum diameter of tumor (tumor size), tumor position, internal echo, microcalcification, vascularization, mulifocality, and ratio of abutment/perimeter (A/P) > 0.25 were independently associated with LLNM metastatic status. In the multivariate analysis, gender, tumor size, mulifocality, position, microcacification, and A/P > 0.25 were independent correlative factors. Comparing the Clin-US nomogram and US features, Clin-US nomogram had the highest AUC both in the training cohort and testing cohorts. The Clin‑US model revealed good discrimination between PTC with LLNM and without LLNM in the training cohort (AUC = 0.813), internal testing cohort (AUC = 0.815) and external testing cohort (AUC = 0.870).ConclusionOur findings suggest that the ClinUS nomogram we newly developed can effectively predict LLNM in PTC patients and could help clinicians choose appropriate surgical procedures.

【 授权许可】

CC BY   
© The Author(s) 2023

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