基于临床及影像学特征的甲状腺乳头状癌淋巴结转移危险因素及预测模型

IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Yuanyuan Deng, Jie Zhang, Jiao Wang, Jinying Wang, Junping Zhang, Lulu Guan, Shasha He, Xiudan Han, Wei Cai, Jixiong Xu
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引用次数: 2

摘要

背景:甲状腺乳头状癌(PTC)通常表现为淋巴结转移,这可能与预后恶化有关。本研究旨在结合术前临床及影像学资料,综合评价PTC淋巴结转移的危险因素,构建预测淋巴结转移风险的nomogram模型。方法:共纳入989例PTC患者,按8:2的比例随机分为训练组和验证组。采用单因素和逐步多因素logistic回归分析PTC淋巴结转移的独立危险因素。采用随机森林法对影响淋巴结转移的独立危险因素进行重要性分析。随后,构建预测淋巴结转移的nomogram,并利用受试者工作特征分析和校准曲线对nomogram的预测效果进行评价。结果:单因素回归分析显示,年龄、性别、体重、收缩压、游离三碘甲状腺原氨酸、结节位置、结节数量、彩色多普勒甲状腺影像报告与数据系统(TI-RADS)分级、影像学上有无肿大的淋巴结、结节直径等因素影响PTC的淋巴结转移。逐步多元回归分析显示,性别、年龄、影像学淋巴结肿大、结节直径、彩色多普勒TI-RADS分级是PTC淋巴结转移的独立危险因素。结合这5个独立的危险因素,构建了nomogram预测模型。训练队列和验证队列的曲线下面积(AUC)分别为0.742和0.765,校准曲线拟合良好。结论:我们的研究表明,PTC淋巴结转移的独立危险因素是性别、年龄、影像学上淋巴结肿大、结节直径和彩色多普勒TI-RADS分级。基于这些独立危险因素构建的nomogram可以更好地预测淋巴结转移的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk factors and prediction models of lymph node metastasis in papillary thyroid carcinoma based on clinical and imaging characteristics.

Background: Papillary thyroid carcinoma (PTC) commonly presents with lymph node metastasis, which may be associated with worsened prognosis. This study aimed to comprehensively evaluate the risk factors of lymph node metastasis in PTC based on preoperative clinical and imaging data and to construct a nomogram model to predict the risk of lymph node metastasis.

Methods: A total of 989 patients with PTC were enrolled and randomly divided into training and validation cohorts in an 8:2 ratio. Independent risk factors for lymph node metastasis in PTC were analyzed using univariate and stepwise multivariate logistic regression. An importance analysis of independent risk factors affecting lymph node metastasis was performed according to the random forest method. Subsequently, a nomogram to predict lymph node metastasis was constructed, and the predictive effect of the nomogram was evaluated using receiver operating characteristic analysis and calibration curves.

Results: Univariate regression analysis revealed that age, sex, body weight, systolic blood pressure, free triiodothyronine, nodule location, nodule number, Thyroid Imaging Reporting and Data System (TI-RADS) grade on color Doppler ultrasound, enlarged lymph node present on imaging, and nodule diameter could affect lymph node metastasis in PTC. Stepwise multivariate regression analysis showed that sex, age, enlarged lymph node present on imaging, nodule diameter, and color Doppler TI-RADS grade were independent risk factors for lymph node metastasis in PTC. Combining these five independent risk factors, a nomogram prediction model was constructed. The area under the curve (AUC) of the nomogram in the training and validation cohorts was 0.742 and 0.765, respectively, with a well-fitted calibration curve.

Conclusion: Our study showed that independent risk factors for lymph node metastasis in PTC were sex, age, enlarged lymph node present on imaging, nodule diameter, and color Doppler TI-RADS grade. The nomogram constructed based on these independent risk factors can better predict the risk of lymph node metastasis.

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来源期刊
Postgraduate Medicine
Postgraduate Medicine 医学-医学:内科
CiteScore
6.10
自引率
2.40%
发文量
110
审稿时长
6-12 weeks
期刊介绍: Postgraduate Medicine is a rapid peer-reviewed medical journal published for physicians. Tracing its roots back to 1916,  Postgraduate Medicine  was established by Charles Mayo, MD, as a peer-to-peer method of communicating the latest research to aid physicians when making treatment decisions, and it maintains that aim to this day. In addition to its core subscriber base, Postgraduate Medicine is distributed to hundreds of US-based physicians within internal medicine and family practice.
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