Nomograms Based on Serum N-glycome for Diagnosis of Papillary Thyroid Microcarcinoma and Prediction of Lymph Node Metastasis

Abstract

Non-invasive biomarkers for the diagnosis and prognosis of papillary thyroid microcarcinoma (PTMC) are still urgently needed. We aimed to characterize the N-glycome of PTMC, and establish nomograms for the diagnosis of PTMC and the prediction of lymph node metastasis (LNM). N-glycome of PTMC (LNM vs. non-LNM, capsular invasion (CI) vs. non-CI (NCI)) and matched healthy controls (HC) were quantitatively analyzed based on mass spectrometry. N-glycan traits associated with PTMC/LNM were used to create binomial logistic regression models and were visualized as nomograms. We found serum N-glycome differed between PTMC and HC in high-mannose, complexity, fucosylation, and bisection, of which, four N-glycan traits (TM, CA1, CA4, and A2Fa) were significantly associated with PTMC. The nomogram based on four traits achieved good performance for the identification of PTMC. Two N-glycan traits (CA4 and A2F0S0G) showed strong associations with LNM. The nomogram based on two traits showed relatively good performance in predicting LNM. We also found differences between CI and NCI in several N-glycan traits, which were not the same as that associated with LNM. This study reported serum N-glycosylation signatures of PTMC for the first time. Nomograms constructed from aberrant glycans could be useful tools for PTMC diagnosis and stratification.

Accurate preoperative prediction of nodal metastasis in papillary thyroid microcarcinoma: Towards optimal management of patients

“…The discriminative power, calibration, and clinical utility of our nomogram in predicting LNM in PTMC were found to be high in both the training and validation sets. Additionally, when compared to other predictive models and nomograms, such as the BRAF V600E mutation model, 14 the sonographic features scoring system, and Liu's nomogram, 19 our tool demonstrated superior accuracy, as evidenced by its higher area under the curve (AUC) values. This indicates a more reliable performance in predicting LNM in PTMC, underscoring the potential of our nomogram to refine risk stratification and guide the management of patients with PTMC.…”

“…12,13 In contrast, a nomogram stands out as a graphical tool designed to fuse multiple variables, offering tailored estimates of the likelihood of specific outcomes, thereby addressing some of the limitations inherent in other approaches. 14 In this research, we aimed to devise and validate a model for the preoperative prediction of LNM in patients with PTMC, incorporating readily available preoperative information including both clinical and ultrasonographic features. 15 We hypothesize that our model will demonstrate robust performance and clinical utility in preoperatively predicting LNM in patients with PTMC and therefore impact on treatment options available for patients with PTMC.…”

“…Despite these advances, these methods have shortcomings such as low accuracy, high cost, invasiveness, lack of standardization, and requirement of large datasets 12,13 . In contrast, a nomogram stands out as a graphical tool designed to fuse multiple variables, offering tailored estimates of the likelihood of specific outcomes, thereby addressing some of the limitations inherent in other approaches 14 …”

High serum mannose in colorectal cancer: a novel biomarker of lymph node metastasis and poor prognosis

“…demonstrated that CRC cells could use the increased aberrant N-glycans to escape immune surveillance. Besides CRC, high-mannose N-glycan levels also elevated in papillary thyroid microcarcinoma ( 27 ), prostate cancer ( 28 ) and breast cancer ( 13 , 25 ), and they were frequently increased in cancer metastasis.…”