Predictive nomogram for central lymph node metastasis in papillary thyroid microcarcinoma based on pathological and ultrasound features

作者全名："Wang, Denghui; Hu, Ji; Deng, Chang; Yang, Zhixin; Zhu, Jiang; Su, Xinliang"

作者地址："[Wang, Denghui; Su, Xinliang] Chongqing Med Univ, Dept Endocrine & Breast Surg, Affiliated Hosp 1, Chongqing, Peoples R China; [Hu, Ji] First Peoples Hosp Chongqing Liang Jiang New Area, Dept Gen Surg, Chongqing, Peoples R China; [Deng, Chang] Chongqing Univ Technol, Dept Endocrine & Breast Surg, Cent Hosp Affiliated, Chongqing, Peoples R China; [Yang, Zhixin] Guiyang City Maternal & Child Hlth Care, Dept Breast & Thyroid, Guiyang, Peoples R China; [Yang, Zhixin] Guiyang City Childrens Hosp, Guiyang, Peoples R China; [Zhu, Jiang] Sichuan Univ, Dept Hepatobiliary Surg, West China Hosp, Chengdu, Peoples R China"

通信作者："Su, XL (通讯作者)，Chongqing Med Univ, Dept Endocrine & Breast Surg, Affiliated Hosp 1, Chongqing, Peoples R China."

来源：FRONTIERS IN ENDOCRINOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001029547500001

JCR分区：Q2

影响因子：3.9

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：nomogram; PTMC; CLNM; pathological; ultrasound

摘要："BackgroundCentral lymph node metastases (CLNM) in papillary thyroid microcarcinoma (PTMC) are common, but management through prophylactic central lymph node dissection (pCLND) remains controversial. In this study, the independent predictors of CLNM in PTMC were retrospectively studied based on ultrasound and pathological data, and we aim to establish the prediction model to predict CLNM in PTMC. MethodsThis study included a total of 1,506 patients who underwent thyroid surgery for PTMC at the First Affiliated Hospital of Chongqing Medical University from 2015 to 2018. Ultrasound and clinicopathological features were summarized and analyzed. Univariate and multivariate analyses were performed to determine the risk factors associated with CLNM. The prediction model is established and verified according to the multivariate analysis results. The Kaplan-Meier curve was used to evaluate the effect of CLNM on survival. ResultsThe CLNM rate was 44.5% (670/1,506). Multivariate analysis showed that men, younger age, smaller diameter, ETE, microcalcification, without Hashimoto's thyroiditis, and multifocal were independent risk predictors of CLNM. Nomogram has a good discriminative ability (C-index: 0.755 in the validation group), and the calibration effect is good. In the DCA curve, the CLNM prediction model performed better net benefit given any high-risk thresholds. The median follow-up time was 30 months (12-59 months), 116 cases were lost, and the follow-up rate was 92.8% (1,506/1,622). Of the 1,506 patients included, 12 (0.8%) experienced recurrence. ConclusionThe likelihood of CLNM can be objectively quantified before surgery by using this reliable and accurate nomogram that combines preoperative ultrasound with clinicopathological features. Clinicians can use this nomogram to assess central lymph node status in patients with PTMC and consider prophylactic CND in patients with high scores."

基金机构：　

基金资助正文：