Construction of prediction models for determining the risk of lateral lymph node metastasis in patients with thyroid papillary carcinoma based on gender stratification

Wu, Wan-Xiao; Qi, Gao-Feng; Feng, Jia-Wei; Ye, Jing; Hong, Li-Zhao; Wang, Fei; Liu, Shengyong; Jiang, Yong

doi:10.1007/s00405-022-07812-x

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…Previous studies have demonstrated that suspicious US features, including a size greater than 1.0 cm, bilateral nodules, capsule contact, microcalcifications, and rich blood flow, as well as non-concomitant HT, are predictors of cervical CLNM in patients with PTC. These features indicate heavier tumor burden and invasiveness, and they are independent risk factors [ 26 – 29 ]. For PTMC, we discovered that LNM was not associated with the nodules' size when using a maximum tumor size reference of 0.5 cm.…”

Section: Discussionmentioning

confidence: 99%

Integrating US-guided FNAB, BRAFV600E mutation, and clinicopathologic characteristics to predict cervical central lymph-node metastasis in preoperative patients with cN0 papillary thyroid carcinoma

Tian

et al. 2023

Eur Arch Otorhinolaryngol

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Background The prevalence of cervical central lymph-node metastasis (CLNM) is high in patients with papillary thyroid carcinoma (PTC). There is considerable controversy surrounding the benefits of prophylactic central lymph-node dissection (pCLND) in patients with clinically negative central compartment lymph nodes (cN0). Therefore, it is crucial to accurately predict the likelihood of cervical CLNM before surgery to make informed surgical decisions. Methods Date from 214 PTC patients (cN0) who underwent partial or total thyroidectomy and pCLND at the Guizhou Provincial People's Hospital were collected and retrospectively analyzed. They were divided into two groups in accordance with cervical CLNM or not. Their information, including clinical characteristics, ultrasound (US) features, pathological results of fine-needle aspirations biopsy (FNAB), and other characteristics of the groups, was analyzed and compared using univariate and multivariate logistic regression analyses. Results A total of 214 patients were eligible in this study. Among them, 43.5% (93/214) of PTC patients had cervical CLNM, and 56.5% (121/214) did not. The two groups were compared using a univariate analyses, and there were no significant differences between the two groups in aspect ratio, boundary, morphology, component, and BRAFV600E (P > 0.05), and there were significant differences between gender, age, maximum tumor size, tumor location, capsule contact, microcalcifications, color Doppler flow imaging (CDFI), and Hashimoto's thyroiditis (HT) (P < 0.05). A multivariate logistic regression analysis was performed to further clarify the correlation of these indices. However, only age (OR = 2.455, P = 0.009), maximum tumor size (OR = 2.586, P = 0.010), capsule contact (OR = 3.208, P = 0.001), and CDFI (OR = 2.225, P = 0.022) were independent predictors of cervical CLNM. Combining these four factors, the area under the receiver-operating characteristic (ROC) curve for the joint diagnosis is 0.8160 (95% 0.7596–0.8725). Univariate analysis indicated that capsule contact (P = 0.001) was a possible predictive factor of BRAFV600E mutation. Conclusions In conclusion, four independent predictors of cervical CLNM, including age < 45 years, tumor size > 1.0 cm, capsule contact, and rich blood flow, were screened out. Therefore, a comprehensive assessment of these risk factors should be conducted when designing individualized treatment regimens for PTC patients.

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Section: Discussionmentioning

confidence: 99%

Integrating US-guided FNAB, BRAFV600E mutation, and clinicopathologic characteristics to predict cervical central lymph-node metastasis in preoperative patients with cN0 papillary thyroid carcinoma

Tian

et al. 2023

Eur Arch Otorhinolaryngol

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The Association between Lymphocytic Thyroiditis and Papillary Thyroid Cancer Harboring Mutant BRAF: A Systematic Review and Meta-Analysis

Perampalam,

Wu,

Gild

et al. 2024

Thyroid®

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Preoperative NLR Combined with Ultrasound to Construct a Predictive Model for Central Lymph Node Metastasis in cN0 Papillary Thyroid Carcinoma

Lan,

Lyu,

Huang

et al. 2024

Preprint

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Objective This study aims to evaluate the preoperative neutrophil-to-lymphocyte ratio (NLR) and ultrasound tumor characteristics to identify risk factors for central lymph node metastasis (CLNM) in clinically lymph node-negative (cN0) papillary thyroid carcinoma (PTC) patients. Based on these risk factors, a nomogram predictive model is developed to aid in formulating individualized treatment plans for clinical practice. Methods A retrospective analysis was conducted on 471 patients who underwent surgery and were pathologically diagnosed with PTC in our hospital between January 2021 and January 2022. Preoperative clinical data and ultrasound findings were collected, including NLR from routine blood tests, age, gender, maximum tumor diameter, tumor location, laterality (unilateral or bilateral), aspect ratio, tumor margin, presence of calcifications, tumor relationship with the thyroid capsule, preoperative thyroglobulin (TG), and thyroid-stimulating hormone (TSH). Based on the presence of CLNM, patients were categorized into a metastasis group and a non-metastasis group. Univariate and multivariate analyses were conducted using SPSS software to identify independent risk factors for CLNM. The patients were randomly divided into a training group and a validation group in a 7:3 ratio. Receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis were generated using R software to assess the feasibility of the predictive model. Results Among the 471 PTC patients, 215 cases (45.6%) were confirmed to have CLNM. Univariate analysis showed that factors such as gender, NLR, tumor diameter, tumor margin, calcifications, aspect ratio, tumor location, tumor relationship with the thyroid capsule, laterality, and TG levels were associated with CLNM. Multivariate logistic regression identified male gender, higher NLR, larger tumor diameter, irregular tumor margins, microcalcifications, and tumor invasion of the thyroid capsule as significant risk factors for CLNM in PTC patients. Based on these findings, a personalized nomogram was constructed and validated internally in two cohorts. The areas under the ROC curve (AUC) for the training and validation groups were 0.836 and 0.825, respectively, indicating good discriminatory power. Hosmer-Lemeshow test results demonstrated good model calibration in both groups. Calibration curves further confirmed the model's predictive accuracy. Conclusion High NLR, microcalcifications, irregular tumor margins, tumor diameter > 1 cm, thyroid capsule invasion, and male gender are independent risk factors for CLNM in PTC patients. The predictive model constructed based on these factors can significantly predict the probability of CLNM in PTC patients. This non-invasive tool will aid in preoperative lymph node assessment and provide effective guidance for surgeons in developing individualized treatment plans.

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Construction of prediction models for determining the risk of lateral lymph node metastasis in patients with thyroid papillary carcinoma based on gender stratification

Cited by 3 publications

References 31 publications

Integrating US-guided FNAB, BRAFV600E mutation, and clinicopathologic characteristics to predict cervical central lymph-node metastasis in preoperative patients with cN0 papillary thyroid carcinoma

Integrating US-guided FNAB, BRAFV600E mutation, and clinicopathologic characteristics to predict cervical central lymph-node metastasis in preoperative patients with cN0 papillary thyroid carcinoma

The Association between Lymphocytic Thyroiditis and Papillary Thyroid Cancer Harboring Mutant BRAF: A Systematic Review and Meta-Analysis

Preoperative NLR Combined with Ultrasound to Construct a Predictive Model for Central Lymph Node Metastasis in cN0 Papillary Thyroid Carcinoma

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