A clinical and molecular pathology prediction model for central lymph node metastasis in cN0 papillary thyroid microcarcinoma
BackgroundThe frequency of thyroid cancer has rapidly increased in recent years globally. Thus, more papillary thyroid microcarcinoma (PTMC) patients are being diagnosed, including clinical lymph node-negative (cN0) patients. Our study attempted to develop a prediction model for assessing the probab...
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1075598/full |
| _version_ | 1797935396850499584 |
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| author | Teng Ma Teng Ma Lulu Wang Xueyan Zhang Yafei Shi |
| author_facet | Teng Ma Teng Ma Lulu Wang Xueyan Zhang Yafei Shi |
| author_sort | Teng Ma |
| collection | DOAJ |
| description | BackgroundThe frequency of thyroid cancer has rapidly increased in recent years globally. Thus, more papillary thyroid microcarcinoma (PTMC) patients are being diagnosed, including clinical lymph node-negative (cN0) patients. Our study attempted to develop a prediction model for assessing the probability of central lymph node metastasis (CLNM) in cN0 PTMC patients.MethodsA total of 595 patients from the Affiliated Hospital of Qingdao University (training cohort: 456 patients) and the Affiliated Hospital of Jining Medical University (verification cohort: 139 patients) who underwent thyroid surgery between January 2020 and May 2022 were enrolled in this study. Their clinical and molecular pathology data were analyzed with multivariate logistic regression to identify independent factors, and then we established a prediction model to assess the risk of CLNM in cN0 PTMC patients.ResultsMultivariate logistic regression analysis revealed that sex, Hashimoto’s thyroiditis (HT), tumor size, extrathyroidal extension, TERT promoter mutations and NRAS mutation were independent factors of CLNM. The prediction model demonstrated good discrimination ability (C-index: 0.757 and 0.753 in the derivation and validation cohorts, respectively). The calibration curve of the model was near the optimum diagonal line, and decision curve analysis (DCA) showed a noticeably better benefit.ConclusionCLNM in cN0 PTMC patients is associated with male sex, tumor size, extrathyroidal extension, HT, TERT promoter mutations and NRAS mutation. The prediction model exhibits good discrimination, calibration and clinical usefulness. This model will help to assess CLNM risk and make clinical decisions in cN0 PTMC patients. |
| first_indexed | 2024-04-10T18:13:47Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-10T18:13:47Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-7c0b08b615df4046b890246f924e125a2023-02-02T09:51:05ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-02-011410.3389/fendo.2023.10755981075598A clinical and molecular pathology prediction model for central lymph node metastasis in cN0 papillary thyroid microcarcinomaTeng Ma0Teng Ma1Lulu Wang2Xueyan Zhang3Yafei Shi4Department of Thyroid Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaQingdao Medical College, Qingdao University, Qingdao, Shandong, ChinaDepartment of Cardiovascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, ChinaQingdao Medical College, Qingdao University, Qingdao, Shandong, ChinaDepartment of Thyroid Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaBackgroundThe frequency of thyroid cancer has rapidly increased in recent years globally. Thus, more papillary thyroid microcarcinoma (PTMC) patients are being diagnosed, including clinical lymph node-negative (cN0) patients. Our study attempted to develop a prediction model for assessing the probability of central lymph node metastasis (CLNM) in cN0 PTMC patients.MethodsA total of 595 patients from the Affiliated Hospital of Qingdao University (training cohort: 456 patients) and the Affiliated Hospital of Jining Medical University (verification cohort: 139 patients) who underwent thyroid surgery between January 2020 and May 2022 were enrolled in this study. Their clinical and molecular pathology data were analyzed with multivariate logistic regression to identify independent factors, and then we established a prediction model to assess the risk of CLNM in cN0 PTMC patients.ResultsMultivariate logistic regression analysis revealed that sex, Hashimoto’s thyroiditis (HT), tumor size, extrathyroidal extension, TERT promoter mutations and NRAS mutation were independent factors of CLNM. The prediction model demonstrated good discrimination ability (C-index: 0.757 and 0.753 in the derivation and validation cohorts, respectively). The calibration curve of the model was near the optimum diagonal line, and decision curve analysis (DCA) showed a noticeably better benefit.ConclusionCLNM in cN0 PTMC patients is associated with male sex, tumor size, extrathyroidal extension, HT, TERT promoter mutations and NRAS mutation. The prediction model exhibits good discrimination, calibration and clinical usefulness. This model will help to assess CLNM risk and make clinical decisions in cN0 PTMC patients.https://www.frontiersin.org/articles/10.3389/fendo.2023.1075598/fullpapillary thyroid microcarcinomacentral lymph node metastasismolecular pathology markersnomogramprediction model |
| spellingShingle | Teng Ma Teng Ma Lulu Wang Xueyan Zhang Yafei Shi A clinical and molecular pathology prediction model for central lymph node metastasis in cN0 papillary thyroid microcarcinoma Frontiers in Endocrinology papillary thyroid microcarcinoma central lymph node metastasis molecular pathology markers nomogram prediction model |
| title | A clinical and molecular pathology prediction model for central lymph node metastasis in cN0 papillary thyroid microcarcinoma |
| title_full | A clinical and molecular pathology prediction model for central lymph node metastasis in cN0 papillary thyroid microcarcinoma |
| title_fullStr | A clinical and molecular pathology prediction model for central lymph node metastasis in cN0 papillary thyroid microcarcinoma |
| title_full_unstemmed | A clinical and molecular pathology prediction model for central lymph node metastasis in cN0 papillary thyroid microcarcinoma |
| title_short | A clinical and molecular pathology prediction model for central lymph node metastasis in cN0 papillary thyroid microcarcinoma |
| title_sort | clinical and molecular pathology prediction model for central lymph node metastasis in cn0 papillary thyroid microcarcinoma |
| topic | papillary thyroid microcarcinoma central lymph node metastasis molecular pathology markers nomogram prediction model |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1075598/full |
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