Risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasis
ObjectiveWe aimed to identify the clinical factors associated with lymph node metastasis (LNM) based on ultrasound characteristics and clinical data, and develop a nomogram for personalized clinical decision-making.MethodsA retrospective analysis was performed on 252 patients with papillary thyroid...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-10-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1287593/full |
| _version_ | 1797645407842467840 |
|---|---|
| author | Juerong Lu Jintang Liao Yunhao Chen Jie Li Xinyue Huang Huajun Zhang Huajun Zhang Huajun Zhang Bo Zhang Bo Zhang |
| author_facet | Juerong Lu Jintang Liao Yunhao Chen Jie Li Xinyue Huang Huajun Zhang Huajun Zhang Huajun Zhang Bo Zhang Bo Zhang |
| author_sort | Juerong Lu |
| collection | DOAJ |
| description | ObjectiveWe aimed to identify the clinical factors associated with lymph node metastasis (LNM) based on ultrasound characteristics and clinical data, and develop a nomogram for personalized clinical decision-making.MethodsA retrospective analysis was performed on 252 patients with papillary thyroid carcinoma (PTC). The patient’s information was subjected to univariate and multivariate logistic regression analyses to identify risk factors. A nomogram to predict LNM was established combining the risk factors. The performance of the nomogram was evaluated using receiver operating characteristic (ROC) curve, calibration curve, cross-validation, decision curve analysis (DCA), and clinical impact curve.ResultsThere are significant differences between LNM and non-LNM groups in terms of age, sex, tumor size, hypoechoic halo around the nodule, thyroid capsule invasion, lymph node microcalcification, lymph node hyperechoic area, peak intensity of contrast (PI), and area under the curve (AUC) of the time intensity curve of contrast (P<0.05). Age, sex, thyroid capsule invasion, lymph node microcalcification were independent predictors of LNM and were used to establish the predictive nomogram. The ROC was 0.800, with excellent discrimination and calibration. The predictive accuracy of 0.757 and the Kappa value was 0.508. The calibration curve, DCA and calibration curve demonstrated that the prediction model had excellent net benefits and clinical practicability.ConclusionAge, sex, thyroid capsule invasion, and lymph node microcalcification were identified as significant risk factors for predicting LNM in patients with PTC. The visualized nomogram model may assist clinicians in predicting the likelihood of LNM in patients with PTC prior to surgery. |
| first_indexed | 2024-03-11T14:45:54Z |
| format | Article |
| id | doaj.art-03e22cc31ae142d090d57b851ff8478a |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-11T14:45:54Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-03e22cc31ae142d090d57b851ff8478a2023-10-30T11:15:28ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-10-011410.3389/fendo.2023.12875931287593Risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasisJuerong Lu0Jintang Liao1Yunhao Chen2Jie Li3Xinyue Huang4Huajun Zhang5Huajun Zhang6Huajun Zhang7Bo Zhang8Bo Zhang9Department of Ultrasonic Imaging, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Ultrasonic Imaging, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Ultrasonic Imaging, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Ultrasonic Imaging, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Ultrasonic Imaging, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Ultrasonic Imaging, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Oncology, National Health Commission of the People's Republic of China (NHC) Key Laboratory of Cancer Proteomics, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaLaboratory of Structural Biology, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Ultrasonic Imaging, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaMolecular Imaging Research Center of Central South University, Changsha, Hunan, ChinaObjectiveWe aimed to identify the clinical factors associated with lymph node metastasis (LNM) based on ultrasound characteristics and clinical data, and develop a nomogram for personalized clinical decision-making.MethodsA retrospective analysis was performed on 252 patients with papillary thyroid carcinoma (PTC). The patient’s information was subjected to univariate and multivariate logistic regression analyses to identify risk factors. A nomogram to predict LNM was established combining the risk factors. The performance of the nomogram was evaluated using receiver operating characteristic (ROC) curve, calibration curve, cross-validation, decision curve analysis (DCA), and clinical impact curve.ResultsThere are significant differences between LNM and non-LNM groups in terms of age, sex, tumor size, hypoechoic halo around the nodule, thyroid capsule invasion, lymph node microcalcification, lymph node hyperechoic area, peak intensity of contrast (PI), and area under the curve (AUC) of the time intensity curve of contrast (P<0.05). Age, sex, thyroid capsule invasion, lymph node microcalcification were independent predictors of LNM and were used to establish the predictive nomogram. The ROC was 0.800, with excellent discrimination and calibration. The predictive accuracy of 0.757 and the Kappa value was 0.508. The calibration curve, DCA and calibration curve demonstrated that the prediction model had excellent net benefits and clinical practicability.ConclusionAge, sex, thyroid capsule invasion, and lymph node microcalcification were identified as significant risk factors for predicting LNM in patients with PTC. The visualized nomogram model may assist clinicians in predicting the likelihood of LNM in patients with PTC prior to surgery.https://www.frontiersin.org/articles/10.3389/fendo.2023.1287593/fullpapillary thyroid carcinomalymph node metastasisultrasoundrisk factornomogram |
| spellingShingle | Juerong Lu Jintang Liao Yunhao Chen Jie Li Xinyue Huang Huajun Zhang Huajun Zhang Huajun Zhang Bo Zhang Bo Zhang Risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasis Frontiers in Endocrinology papillary thyroid carcinoma lymph node metastasis ultrasound risk factor nomogram |
| title | Risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasis |
| title_full | Risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasis |
| title_fullStr | Risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasis |
| title_full_unstemmed | Risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasis |
| title_short | Risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasis |
| title_sort | risk factor analysis and prediction model for papillary thyroid carcinoma with lymph node metastasis |
| topic | papillary thyroid carcinoma lymph node metastasis ultrasound risk factor nomogram |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1287593/full |
| work_keys_str_mv | AT jueronglu riskfactoranalysisandpredictionmodelforpapillarythyroidcarcinomawithlymphnodemetastasis AT jintangliao riskfactoranalysisandpredictionmodelforpapillarythyroidcarcinomawithlymphnodemetastasis AT yunhaochen riskfactoranalysisandpredictionmodelforpapillarythyroidcarcinomawithlymphnodemetastasis AT jieli riskfactoranalysisandpredictionmodelforpapillarythyroidcarcinomawithlymphnodemetastasis AT xinyuehuang riskfactoranalysisandpredictionmodelforpapillarythyroidcarcinomawithlymphnodemetastasis AT huajunzhang riskfactoranalysisandpredictionmodelforpapillarythyroidcarcinomawithlymphnodemetastasis AT huajunzhang riskfactoranalysisandpredictionmodelforpapillarythyroidcarcinomawithlymphnodemetastasis AT huajunzhang riskfactoranalysisandpredictionmodelforpapillarythyroidcarcinomawithlymphnodemetastasis AT bozhang riskfactoranalysisandpredictionmodelforpapillarythyroidcarcinomawithlymphnodemetastasis AT bozhang riskfactoranalysisandpredictionmodelforpapillarythyroidcarcinomawithlymphnodemetastasis |