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

Issue:

2024 24

Page:

4608-4615

Research Field:

Publishing date:

Info

Title:

Risk factors analysis and model construction of cervical lymph node metastasis in papillary thyroid carcinoma

Author(s):

XING Zhijing¹; LU Dan¹; ZHANG Qiaomeng¹; ZHU Ping¹; SHI Changbei²; YUAN Quan²; AN Yuan²; LI Lin¹; 2

1.Shaanxi University of Chinese Medicine,Shannxi Xianyang 712046,China;2.Shaanxi Cancer Hospital,Shannxi Xi'an 710061,China.

Keywords:

papillary thyroid carcinoma; cervical lymph node metastasis; risk factors; gene mutation; nomogram

PACS:

R736.1

DOI:

10.3969/j.issn.1672-4992.2024.24.005

Abstract:

Objective:To analyze the risk factors of cervical lymph node metastasis(LNM)in patients with papillary carcinoma of thyroid(PCT)before operation,and to construct a nomogram model and evaluate the efficacy of the model.Methods:A total of 210 patients who underwent first surgery in Shaanxi Cancer Hospital from April 2020 to June 2024 were enrolled and randomly divided into training set(150 cases)and validation set(60 cases).The clinical data,ultrasound features,preoperative serum thyroglobulin(PS-Tg)and BRAF V600E gene mutation were retrospectively analyzed.According to the postoperative pathological results,the patients were divided into lymph node metastasis group and lymph node non-metastasis group.Univariate and multivariate logistic regression were used to analyze the risk factors affecting cervical LNM in PTC patients and construct a nomogram model.Receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA)were used to evaluate the diagnostic efficacy and net clinical benefit of the model.Results:Multivariate logistic regression analysis showed that age(OR=0.96,95%CI:0.92~0.99,P=0.01),gender(OR=2.21,95%CI:0.86~5.69,P=0.099),tumor multifocality(OR=5.05,95%CI:1.87~13.67,P=0.001),nodule distribution(OR=0.16,95%CI:0.03~1.01,P=0.051).The above indicators were included to construct a nomogram prediction model,which was verified in the training set and validation set.The area under curve(AUC)of ROC curve in the training set and validation set were 0.748(95%CI:0.670~0.825)and 0.635(95%CI:0.489~0.782 ).The model had good discrimination,and the calibration curve was basically consistent with the ideal curve.Conclusion:The nomogram based on multiple indicators can predict the risk of cervical LNM in preoperative PTC patients,which can provide certain help for clinical diagnosis and treatment and individualized guidance for patients.

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