A Retrospective Analysis: A Predictive Model Using Platelets and Neutrophil-to- Lymphocyte Ratio for the Number of Lymph Node Metastasis in Papillary Thyroid Carcinoma

Abstract

Objective The aim of this study was to investigate the high-risk clinical factors for large-number lymph node metastases (LNLNM) inthyroid papillary carcinoma (PTC). Methods The clinicopathological data from the 731 PTC patients who underwent thyroid operation between September 2021to October 2022 in the surgical oncology of Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine were collected. Univariate and multivariate logistic analyses were conducted to identify risk factors for LNLNM in PTC. A predictive model for assessing LNLNM in PTC was established and validated by using receiver operating characteristic curves (ROC), the Hosmer-Lemeshow (HL)test, calibration curves, and decision curve analysis (DCA). Results Age, tumor diameter, platelets and neutrophil-to-lymphocyte ratio (NLR) were identified as independent risk factors for LNLNM in PTC patients. A predictive model was developed to evaluate the risk of LNLNMwith an area under the curve (AUC) of 0.827 (P<0.001, 95%CI: 0.784-0.870) and the specificity and sensitivity were both 75.8%. The AUC of the validation group was 0.824(P<0.001, 95%CI: 0.757-0.890) with a specificity of 79.5% and a sensitivity of 76.0%. Furthermore, themodel demonstrated good calibration through the HL test and favorable diagnostic value by calibration curve and DCA. Conclusion Age, tumor diameter, platelets and NLRare high-risk factors for LNLNM in PTC, and the predictive model established in combination with the above factors couldeffectively predict the occurrence of LNLNM in PTC. This study provides support for surgeons to accurately predict the possibility of LNLNM and develop personalized treatment plans before surgery.