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Nomogram to predict central lymph node metastasis in papillary thyroid carcinoma

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Abstract

Central lymph node metastasis (CLNM) of papillary thyroid carcinoma (PTC) is common. In our study, we built a nomogram to predict CLNM. We retrospectively analyzed 1,392 PTC patients. This group of patients was divided into a training cohort (including 1,009 patients) and a validation cohort (including 383 patients). Analyses of the correlation between inflammatory indicators, ultrasonic characteristics, pathological characteristics and CLNM were conducted. In the training cohort and validation cohort, the metastatic rates of CLNM were 60.16% and 64.23%, respectively. Univariate and multivariate logistic regression analyses demonstrated that Hashimoto’s thyroiditis (HT), calcification, multifocality, capsule invasion, PLR (platelet-lymphocyte ratio) ≤ 130.34, large tumors and middle and lower positions were independent risk factors for CLNM. Then, we constructed a nomogram. The nomogram had good discrimination regardless of whether there was CLNM, with a C-index of 0.809. The calibration curve indicated that the nomogram had good visual and quantitative consistency (p = 0.213). Decision curve analysis showed that the nomogram improved the net clinical benefit with a threshold probability of 0–82% in the training cohort and 0–71% in the validation cohort. We constructed a nomogram to predict CLNM in PTC and assist surgeons in making personalized clinical decisions for PTC.

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Data availability

No datasets were generated or analysed during the current study.

Abbreviations

CLNM:

Central lymph node metastasis

PTC:

Papillary thyroid carcinoma

ATA:

American Thyroid Association

cN0:

Clinical central lymph node negativity

CT:

Computed tomography

NLR:

Neutrophil-lymphocyte ratio

LMR:

Lymphocyte-monocyte ratio

PLR:

Platelet-lymphocyte ratio

SII:

Systemic inflammation index

TG:

Thyroglobulin

TSHAb:

Thyrotropin receptor antibody

TSH:

Thyroid stimulating hormone

ROC:

Receiver operating characteristic

DCA:

Decision curve analysis

HT:

Hashimoto’s thyroiditis

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Acknowledgements

Not applicable.

Funding

This study received funding support from Southwest Medical University (No. 2021- ZRQN096).

Author information

Authors and Affiliations

  1. Department of Thyroid Surgery, Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Luzhou, 646000, Sichuan Province, China

    Dehui Qiao, Xian Deng, Xu Li, Rongjia Zhang, Hui Yang & Xiangyu Zhou

  2. Operating Room of Affiliated Hospital of Southwest Medical University, Luzhou, China

    Ruichen Liang

  3. Luzhou Center for Disease Control and Prevention, Luzhou, China

    Zhi Lei

Authors
  1. Dehui Qiao
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  2. Xian Deng
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  3. Ruichen Liang
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  4. Xu Li
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  7. Hui Yang
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  8. Xiangyu Zhou
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Contributions

Conceptualization, Dehui Qiao and Xiang-yu Zhou. ; methodology, Xian Deng and Rui-chen Liang; software, Rui-chen Liang; validation, Xu Li and Rong-jia Zhang; formal analysis, Zhi Lei; investigation, Zhi Lei; resources, Xian Deng and Hui Yang; data curation, Xu Li and Rong-jia Zhang; writing—original draft preparation, Dehui Qiao; writing—review and editing, Dehui Qiao and Xiang-yu Zhou; visualization, Rui-chen Liang; supervision, Xiang-yu Zhou; project administration, Xiang-yu Zhou; funding acquisition, Dehui Qiao and Xiang-yu Zhou. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Xiangyu Zhou.

Ethics declarations

Institutional Review Board Statement

This study was conducted in accordance with the Helsinki Declaration and approved by the Ethics Committee of the Affiliated Hospital of Southwest Medical University (File No. KY2023338).

Informed consent

Due to the retrospective nature of the study, the ethics committee waived patient consent.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Qiao, D., Deng, X., Liang, R. et al. Nomogram to predict central lymph node metastasis in papillary thyroid carcinoma. Clin Exp Metastasis (2024). https://doi.org/10.1007/s10585-024-10285-3

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