|Table of Contents|

Establishment and validation of a risk-predictive model for central lymph node metastasis in papillary thyroid carcinoma with Hashimoto's thyroiditis

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 12
Page:
2239-2247
Research Field:
Publishing date:

Info

Title:
Establishment and validation of a risk-predictive model for central lymph node metastasis in papillary thyroid carcinoma with Hashimoto's thyroiditis
Author(s):
LI Hui1; HUANG Yuting2; LOU Pengwei3; WANG Kai4; MA Li1
1.Department of Endocrine;2.Department of Medical Administration,Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University,Xinjiang Urumqi 830000,China;3.Department of Big Data,College of Information Engineering,Xinjiang Institute of Engineering,Xinjiang Urumqi 830000,China;4.Department of Medical Engineering and Technology,Xinjiang Medical University,Xinjiang Urumqi 830011,China.
Keywords:
papillary thyroid carcinoma(PTC); Hashimoto's thyroiditis(HT); central lymph node metastasis (CLNM); prediction model; nomogram
PACS:
R736.1
DOI:
10.3969/j.issn.1672-4992.2023.12.012
Abstract:
Objective:To evaluate the predictive factors of central lymph node metastasis (CLNM) in PTC with HT patients.And establish a nomogram to predict the possibility of CLNM in PTC with HT patients.Methods:We retrospectively collected the data of 4 171 PTC patients who underwent surgery at our hospital from January 2018 to December 2021.Finally,a total of 671 PTC patients with HT were enrolled.Among them,468 patients comprised the training cohort for nomogram development,while the other 203 formed the validation cohort to validate the model's performance.The least absolute shrinkage and selection operator (LASSO) regression models were used for factors selection,and the multivariate logistic regression analysis was used to establish the prediction model.A nomogram for predicting CLNM was established and internally validated.Results:LASSO regression model showed that seventeen variables may be the factors affecting the occurrence of CLNM (P<0.05).Subsequently,multivariate logistic regression analysis showed that lower age,hyperechoic in nodule(HIN),larger diameter,multifocality,extrathyroidal extension(ETE),cervical lymph nodes enlargement (ECLN) and carcino-embryonic antigen (CEA) were finalized risk factors for CLNM(P<0.05).A nomogram of CLNM in PTC with HT patients was constructed based on influencing factors and underwent internal validation.By establishing the prediction model,the area under the ROC curve(AUC) of CLNM in the training group was 0.774(95%CI,0.725~0.824),and the AUC in the validation group was 0.781(95%CI,0.712~0.850).The preoperative nomogram showed good calibration and discrimination for the training and validation cohorts,as well as for the combined data set.Conclusion:The nomogram prediction model constructed in this study has a good prediction effect on the occurrence of central regional lymph node metastasis (CLNM) in patients with papillary thyroid cancer associated with Hashimoto's thyroiditis.To provide a reasonable reference for clinical treatment plans,and to help clinicians to develop personalized treatment plans for patients.

References:

［1］LIU Y,CHEN TY,YANY ZY,et al.Identification of hub genes in papillary thyroid carcinoma:robust rank aggregation and weighted gene co-expression network analysis［J］.J Transl Med,2020,18(1):170.
［2］ZHAO W,HE L,ZHU J,et al.A nomogram model based on the preoperative clinical characteristics of papillary thyroid carcinoma with Hashimoto's thyroiditis to predict central lymph node metastasis［J］.Clin Endocrinol(Oxf),2021,94(2):310-321.
［3］LEE JH,KIM Y,CHOI JW,et al.The association between papillary thyroid carcinoma and histologically proven Hashimoto's thyroiditis:a meta-analysis［J］.Eur J Endocrinol,2013,168(3):343-349.
［4］DEL RIO P,CATALDO S,SOMMARUGA L,et al.The association between papillary carcinoma and chronic lymphocytic thyroiditis:does it modify the prognosis of cancer［J］.Minerva Endocrinol,2008,33(1):1-5.
［5］JIN K,LI L,LIU Y,et al.The characteristics and risk factors of central compartment lymph node metastasis in cN0 papillary thyroid carcinoma coexistent with Hashimoto's thyroiditis［J］.Gland Surg,2020,9(6):2026-2034.
［6］IRNI A,VITA R,MAGLIOLO E,et al.One-third of an archivial series of papillary thyroid cancer(years 2007-2015) has coexistent chronic lymphocytic thyroiditis,which is associated with a more favorable tumor-node-metastasis staging［J］.Front Endocrinol(Lausanne),2017，8:337.
［7］LIANG J,ZENG W,FANG F,et al.Clinical analysis of Hashimoto thyroiditis coexistent with papillary thyroid cancer in 1392 patients［J］.Acta Otorhinolaryngol Ital,2017,37(5):393-400.
［8］MO R,SHI R,HU Y,et al.Nomogram-based prediction of the risk of diabetic retinopathy:a retrospective study［J］.J Diabetes Res,2020,2020:7261047.
［9］HUANG YQ,LIANG CH,HE L,et al.Development and validation of a radiomics nomogram for preoperative prediction of lymph node metastasis in colorectal cancer［J］.J Clin Oncol,2016,34(18):2157-2164.
［10］FAN T,WANG H,WANG J,et al.Nomogram to predict the risk of acute kidney injury in patients with diabetic ketoacidosis:an analysis of the MIMIC-III database［J］.BMC Endocr Disord,2021,21(1):37.
［11］CARVALHO GMC,LEITE TT,LIBORIO AB.Prediction of 60-day case fatality in critically Ill patients receiving renal replacement therapy:external validation of a prediction model［J］.Shock,2018,50(2):156-161.
［12］VICKERS AJ,CRONIN AM,ELKIN EB,et al.Extensions to decision curve analysis,a novel method for evaluating diagnostic tests,prediction models and molecular markers［J］.BMC Med Inform Decis Mak,2008,8:53.
［13］FITZGERALD M,SAVILLE BR,LEWIS RJ.Decision curve analysis［J］.JAMA,2015,313(4):409-410.
［14］ KEBEBEW E,CLARK OH.Differentiated thyroid cancer:"complete" rational approach［J］.World J Surg,2000,24(8):942-951.
［15］CHEN AY,JEMAL A,WARD EM.Increasing incidence of differentiated thyroid cancer in the United States,1988-2005［J］.Cancer,2009,115(16):3801-3807.
［16］SAKIZ D,SENCAR ME,CALAPKULU M,et al.The effects of chronic lymphocytic thyroiditis on clinicopathologic factors in papillary thyroid cancer［J］.Endocr Pract,2021,27(12):1199-1204.
［17］LAI V,YEN TW,ROSE BT,et al.The effect of thyroiditis on the yield of central compartment lymph nodes in patients with papillary thyroid cancer［J］.Ann Surg Oncol,2015,22(13):4181-4186.
［18］SPECHT MC,KATTAN MW,GINEN M,et al.Predicting nonsentinel node status after positive sentinel lymph biopsy for breast cancer:clinicians versus nomogram［J］.Ann Surg Oncol,2005,12(8):654-659.
［19］ROSS PL,GERIGK C,GINEN M,et al.Comparisons of nomograms and urologists' predictions in prostate cancer［J］.Semin Urol Oncol,2002,20(2):82-88.
［20］LI XY,ZHANG B,LIN YS.The interpretation of 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer［J］.Chinese Journal of Otolaryngology Surgery,2017,52(4):309-315.
［21］FENG JW,QU Z,QIN AC,et al.Significance of multifocality in papillary thyroid carcinoma［J］.Eur J Surg Oncol,2020,46(10):1820-1828.
［22］ZHU F,SHEN YB,LI FQ,et al.The effects of Hashimoto thyroiditis on lymph node metastases in unifocal and multifocal papillary thyroid carcinoma:a retrospective chinese cohort Study［J］.Medicine (Baltimore),2016,95(6):e2674.
［23］ZHONG M,ZHANG Z,XIAO Y,et al.The predictive value of ACR TI-RADS classification for central lymph node metastasis of papillary thyroid carcinoma:a retrospective study［J］.Int J Endocrinol,2022,2022:4412725.
［24］MOHAMED HE,MOHAMED SE,ANWAR MA,et al.The significance of nlarged cervical lymph nodes(ECLN) in diagnosing thyroid cancer［J］.J Cancer Res Ther,2016,12(2):1006-1009.
［25］FERREIRA LB,GIMBA E,VINAGRE J,et al.Molecular aspects of thyroid calcification［J］.Int J Mol Sci,2020,21(20):7718.
［26］KIM BK,CHOI YS,KWON HJ,et al.Relationship between patterns of calcification in thyroid nodules and histopathologic findings［J］.Endocr J,2013,60(2):155-160.
［27］ KAZAURE HS,ROMAN SA,SOSA JA.The impact of age on thyroid cancer staging［J］.Curr Opin Endocrinol Diabetes Obes,2018,25(5):330-334.
［28］ZANON DK,PATEL SG,SHAH JP.Changes in the 8th edition of the American Joint Committee on Cancer (AJCC) staging of head and neck cancer:rationale and implications［J］.Curr Oncol Rep,2019,21(6):52.
［29］FUKS A,BANJO C,SHUSTER J,et al.Carcinoembryonic antigen (CEA):molecular biology and clinical significance［J］.Biochim Biophys Acta,1975,417(2):123-152.

Memo

Memo:
-
Last Update: 1900-01-01