A Nomogram Based on Clinical and Ultrasound Characteristics to Predict Central Lymph Node Metastasis of Papillary Thyroid Carcinoma

• Published in: Frontiers in endocrinology (Lausanne) Vol. 12; p. 666315
• Main Authors: Feng, Jia-Wei, Hong, Li-Zhao, Wang, Fei, Wu, Wan-Xiao, Hu, Jun, Liu, Sheng-Yong, Jiang, Yong, Ye, Jing
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 28.04.2021
• Subjects: Adult; Aged; central lymph node metastasis; central neck dissection; Endocrinology; Female; Follow-Up Studies; Humans; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis; Male; Middle Aged; nomogram; Nomograms; papillary thyroid carcinoma; Prognosis; Retrospective Studies; Risk Factors; ROC Curve; surgery; Thyroid Cancer, Papillary - diagnostic imaging; Thyroid Cancer, Papillary - secondary; Thyroid Cancer, Papillary - surgery; Thyroid Neoplasms - diagnostic imaging; Thyroid Neoplasms - pathology; Thyroid Neoplasms - surgery; Thyroidectomy - methods; Ultrasonography - methods; Young Adult; central neck dissection; nomogram; papillary thyroid carcinoma; central lymph node metastasis; surgery
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2021.666315

The status of lymph nodes in the central compartment is crucial to determining the surgical strategies for papillary thyroid carcinoma (PTC). We aimed to develop a nomogram for predicting central lymph node metastasis (CLNM). A total of 886 PTC patients who underwent total thyroidectomy or lobectomy with central neck dissection (CND) from July 2019 to June 2020 were retrospectively retrieved. Clinical and ultrasound features were collected. Univariate and multivariate analysis were performed to determine risk factors of CLNM. A nomogram for predicting CLNM was developed, internal and external calibration was performed for the established model. Variables (sex, chronic lymphocytic thyroiditis, tumor size, the number of foci, tumor location, margin) significantly associated with CLNM were included in the nomogram. The nomogram showed excellent calibration in the training group and validation group, with area under curves of 0.806 (95% CI, 0.771 to 0.825), and 0.799 (95% CI, 0.778-0.813) respectively. Through this accurate and easy-to-use nomogram, the possibility of CLNM can be objectively quantified preoperatively. Clinicians can use this nomogram to evaluate the status of lymph nodes in PTC patients and consider prophylactic CND for those with high scores.