Risk prediction for <1 cm lateral lymph node metastasis in papillary thyroid microcarcinoma
BackgroundBecause the diameter of the suspicious lymph nodes is less than 1 cm and adjacent to important structures in the neck, the diagnosis of small LLNM is important but difficult without the help of fine needle aspiration (FNA). There are no relevant reports of risk factors that predict the ris...
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| Format: | Article |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1235354/full |
| _version_ | 1797628967849558016 |
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| author | Chengxin Zhang Siqi Fu He Liu Shuai Xue |
| author_facet | Chengxin Zhang Siqi Fu He Liu Shuai Xue |
| author_sort | Chengxin Zhang |
| collection | DOAJ |
| description | BackgroundBecause the diameter of the suspicious lymph nodes is less than 1 cm and adjacent to important structures in the neck, the diagnosis of small LLNM is important but difficult without the help of fine needle aspiration (FNA). There are no relevant reports of risk factors that predict the risk of suspicious <1 cm LLNM.MethodsA total of 159 PTMC patients with suspicious <1 cm LLNM were included in the study. Multivariate logistic regression analysis was used to identify ultrasound independent predictors of LLNM. A predictive model was developed according to multivariate logistic regression and evaluated by Hosmer-Lemeshow fit test.ResultsAge ≤ 38 years old, the largest PTMC was located in the upper part, and the presence of liquefaction or microcalcification in suspicious lymph nodes were independent risk factors for LLNM (univariate analysis P = 0.00, 0.00, 0.00; multivariate analysis P = 0.00, 0.02, 0.00. OR = 4.66 [CI: 1.78-12.21], 3.04 [CI: 1.24-7.46], 6.39 [CI: 1.85-22.00]). The predictive model for the diagnosis of suspicious <1 cm lymph nodes was established as: P = ex/(1 + ex). X = -1.29 + (1.11 × whether the largest tumor is located in the upper part) + (1.54 × whether the age is ≤ 38 years) + (1.85 × whether the suspicious lymph nodes have liquefaction/microcalcification). The Hosmer-Lemeshow fit test was used to test the predicted ability, and it found that the predictive model had a good fit and prediction accuracy (X2 = 6.214, P = 0.623 > 0.05). Chi squared trend analysis showed that the increase in the number of risk factors gradually increased the malignancy possibility of suspicious <1 cm lymph nodes (chi squared trend test, P = 0.00).ConclusionsAge ≤ 38 years old, the largest PTMC located in the upper part, and the presence of liquefaction or microcalcification in suspicious lymph nodes were independent risk factors for suspicious <1 cm LLNM in PTMC patients. Our result show that it is feasible to evaluate the malignant possibility of these lymph nodes using the number of risk factors. |
| first_indexed | 2024-03-11T10:46:41Z |
| format | Article |
| id | doaj.art-237d3484d4b14a8d8be27279870b9cf6 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-11T10:46:41Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-237d3484d4b14a8d8be27279870b9cf62023-11-14T02:06:33ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-11-011410.3389/fendo.2023.12353541235354Risk prediction for <1 cm lateral lymph node metastasis in papillary thyroid microcarcinomaChengxin Zhang0Siqi Fu1He Liu2Shuai Xue3Business College, Guilin University Of Electronic Technology, Guilin, Guangxi, ChinaBusiness College, Guilin University Of Electronic Technology, Guilin, Guangxi, ChinaBusiness College, Guilin University Of Electronic Technology, Guilin, Guangxi, ChinaGeneral Surgery Center, Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, Jilin, ChinaBackgroundBecause the diameter of the suspicious lymph nodes is less than 1 cm and adjacent to important structures in the neck, the diagnosis of small LLNM is important but difficult without the help of fine needle aspiration (FNA). There are no relevant reports of risk factors that predict the risk of suspicious <1 cm LLNM.MethodsA total of 159 PTMC patients with suspicious <1 cm LLNM were included in the study. Multivariate logistic regression analysis was used to identify ultrasound independent predictors of LLNM. A predictive model was developed according to multivariate logistic regression and evaluated by Hosmer-Lemeshow fit test.ResultsAge ≤ 38 years old, the largest PTMC was located in the upper part, and the presence of liquefaction or microcalcification in suspicious lymph nodes were independent risk factors for LLNM (univariate analysis P = 0.00, 0.00, 0.00; multivariate analysis P = 0.00, 0.02, 0.00. OR = 4.66 [CI: 1.78-12.21], 3.04 [CI: 1.24-7.46], 6.39 [CI: 1.85-22.00]). The predictive model for the diagnosis of suspicious <1 cm lymph nodes was established as: P = ex/(1 + ex). X = -1.29 + (1.11 × whether the largest tumor is located in the upper part) + (1.54 × whether the age is ≤ 38 years) + (1.85 × whether the suspicious lymph nodes have liquefaction/microcalcification). The Hosmer-Lemeshow fit test was used to test the predicted ability, and it found that the predictive model had a good fit and prediction accuracy (X2 = 6.214, P = 0.623 > 0.05). Chi squared trend analysis showed that the increase in the number of risk factors gradually increased the malignancy possibility of suspicious <1 cm lymph nodes (chi squared trend test, P = 0.00).ConclusionsAge ≤ 38 years old, the largest PTMC located in the upper part, and the presence of liquefaction or microcalcification in suspicious lymph nodes were independent risk factors for suspicious <1 cm LLNM in PTMC patients. Our result show that it is feasible to evaluate the malignant possibility of these lymph nodes using the number of risk factors.https://www.frontiersin.org/articles/10.3389/fendo.2023.1235354/fullrisk factorpredictive modellateral lymph node metastasispapillary thyroid microcarcinomalateral lymph node dissection |
| spellingShingle | Chengxin Zhang Siqi Fu He Liu Shuai Xue Risk prediction for <1 cm lateral lymph node metastasis in papillary thyroid microcarcinoma Frontiers in Endocrinology risk factor predictive model lateral lymph node metastasis papillary thyroid microcarcinoma lateral lymph node dissection |
| title | Risk prediction for <1 cm lateral lymph node metastasis in papillary thyroid microcarcinoma |
| title_full | Risk prediction for <1 cm lateral lymph node metastasis in papillary thyroid microcarcinoma |
| title_fullStr | Risk prediction for <1 cm lateral lymph node metastasis in papillary thyroid microcarcinoma |
| title_full_unstemmed | Risk prediction for <1 cm lateral lymph node metastasis in papillary thyroid microcarcinoma |
| title_short | Risk prediction for <1 cm lateral lymph node metastasis in papillary thyroid microcarcinoma |
| title_sort | risk prediction for 1 cm lateral lymph node metastasis in papillary thyroid microcarcinoma |
| topic | risk factor predictive model lateral lymph node metastasis papillary thyroid microcarcinoma lateral lymph node dissection |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1235354/full |
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