Construction and validation of a clinical prediction model for central lymph node metastasis in patients with high age-risk papillary thyroid cancer
10.3760/cma.j.cn.115807-20231128-00171
- VernacularTitle:≥55岁甲状腺乳头状癌患者中央区淋巴结转移的临床预测模型构建与验证
- Author:
Hanlin SUN
1
;
Keyu YIN
;
Hongqiang LI
;
Yifeng TANG
;
Weihao LIU
;
Yifei ZHANG
;
Detao YIN
Author Information
1. 郑州大学第一附属医院甲状腺外科 河南省甲状腺癌多学科诊疗工程研究中心 河南省甲状腺癌医学重点实验室，郑州 450052
- Keywords:
Differentiated thyroid cancer;
Central lymph node metastasis;
Clinical prediction models
- From:
Chinese Journal of Endocrine Surgery
2024;18(1):45-50
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for central lymph node metastasis (CLNM) in patients with papillary thyroid cancer (PTC) aged 55 years and above, and to construct a predictive model with columnar graph.Methods:This retrospective study included 406 PTC patients aged 55 and above, treated at the First Affiliated Hospital of Zhengzhou University from Nov. 2019 to Feb. 2022. Data on demographic characteristics, disease features, and laboratory test results were collected. Univariate and multivariate logistic regression analyses were used to identify risk factors for CLNM and develop a clinical prediction model and nomogram.Results:The study involved 406 patients, divided into a modeling group (285 patients) and a validation group (121 patients). The predictive model identified independent risk factors for CLNM. In the modeling group, the model demonstrated a ROC AUC of 0.769, with 82.6% sensitivity, 63.0% specificity, and 67.7% accuracy. The validation group showed 66.7% sensitivity, 74.5% specificity, and 72.7% accuracy, with an AUC of 0.760. Hosmer-Lemeshow tests indicated good fit in both groups. Decision curve analysis confirmed the model's clinical decision-making value, showing better performance than traditional strategies and good generalizability and reliability.Conclusions:Sex, maximum tumor diameter, bilateral involvement of thyroid lobes, clinically evident cervical lymph nodes, and local invasion are independent predictive factors for CLNM in patients over 55 with papillary thyroid carcinoma (PTC). A clinical risk stratification nomogram model based on these risk factors demonstrates good predictive performance.
