Predictive model for cervical lymph node metastasis of papillary thyroid carcinoma based on ultrasound and thyroglobulin infine-needle aspirate fluid detection
10.3760/cma.j.issn.1004-4477.2020.02.006
- VernacularTitle:基于超声与细针穿刺洗脱液甲状腺球蛋白检测建立甲状腺乳头状癌颈侧区淋巴结转移的预测模型
- Author:
Yanyu LI
1
;
Qian WANG
;
Gonglin FAN
;
Jianghong LYU
;
Lilong XU
;
Leqi WANG
;
Li GAO
;
Deguang ZHANG
;
Gaofei HE
;
Jiang ZHU
Author Information
1. 浙江大学医学院附属邵逸夫医院超声科 浙江大学邵逸夫临床医学研究所，杭州 310016；浙江省临海市第一人民医院超声科，临海 317000
- From:
Chinese Journal of Ultrasonography
2020;29(2):131-137
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a predictive model of lateral lymph node metastasis in patients with papillary thyroid carcinoma(PTC), and further to compare the diagnostic efficiency of this model with the suspected abnormal lymph node thyroglobulin in fine-needle aspirate fluid (FNA-Tg) for lateral lymph node metastasis.Methods:The preoperative clinical and ultrasonographic data of 110 patients (257 lymph nodes) who underwent PTC cervical lymph node dissection were retrospectively analyzed. According to the postoperative pathological results, they were divided into lateral lymph node metastasis and non-metastasis group. Regression analysis was used to screen out independent risk factors affecting lateral lymph node metastasis and establish a predictive model. The ROC curve was used to evaluate the diagnostic efficacy and the best diagnostic cut-off point.Results:Prediction model: Logit( P)=-2.987+ 2.189(S/L ratio of lymph nodes)+ 1.748(hilum absent)+ 2.030(hyperechoic)+ 1.849(vascular abnormalities). The sensitivity, specificity, accuracy and AUC of the prediction model in the diagnosis of lateral lymph node metastasis were 92.1%, 83.9%, 87.9% and 0.929, respectively. The Homser-Lemeshow goodness of fit test showed that the Logistic model has a good fitting effect. The sensitivity, specificity, accuracy, and AUC of FNA-Tg in the diagnosis of lateral lymph node metastasis were 87.4%, 95.4%, 90.3% and 0.968, respectively. The sensitivity, specificity, accuracy, and AUC of the combined diagnosis of the predictive model and FNA-Tg were 92.9%, 96.9%, 94.2% and 0.989, respectively. Conclusions:The model has a good predictive value for PTC cervical lymph node metastasis. Combined with FNA-Tg, it can improve its diagnostic efficiency and provide more valuable information for the decision-making of clinical surgical procedures.
