Risk Factors And Nomogram For Cervical Lymph Node Metastasis In Papillary Thyroid Carcinoma

Background and purpose: Papillary thyroid carcinoma(PTC)often have metastasis in the neck lymph nodes(LNM).Inadequate treatment or overtreatment can either lead to tumor metastasis or reduce the life quality of patients.Therefore,a method that can accurately assess LNM is needed.In this study,we explored the risk factors of LNM from the clinicopathological characteristics of PTC patients and constructed the prediction models of central lymph nodes metastasis(CLNM)and lateral cervical lymph nodes metastasis(LLNM).Method: By retrospectively studying the clinicopathological data of 704 consecutive PTC patients of our medical center between November 2020 and October2022,the appropriate statistical methods were used for comparison of qualitative variables among PTC patients.Based on those results,the nomogram models were constructed respectively,and the sensitivity and predictability of the models were evaluated.Result: In this study,we found males(OR=1.855,P=0.005),age <55(OR=1.855,P=0.005),tumor diameter >1cm(1cm<D≤2cm,OR=2.183,P<0.001;2cm<D≤4cm,OR=3.148,P<0.001),multifocal(OR=1.709,P= 0.003),located in the isthmus(OR=10.772,P=0.034),with calcification(OR=1.516,P=0.066),and tumor extravasation(OR=1.665,P=0.049)were independent risk factors for CLNM in patients with PTC.1cm<tumor diameter ≤2cm(OR=2.239,P=0.005),2cm<diameter ≤4cm(OR=4.716,P=0.001),diameter >4cm(OR=44.124,P=0.001),with calcification(OR=2.001,P=0.046),CLNM(OR=4.897,P<0.001),located in the lower portion(OR=0.419,P=0.007),aspect ratio >1(OR=2.043,P=0.022)and Tg Ab >5 times(OR=2.359,P=0.008).The nomogram model of CLNM and LLNM in PTC patients was constructed based on the above results.Conclusion: The prediction models of CLNM and LLNM in PTC patients based on risk factors,such as patient age,gender,ultrasound characteristics,pathological characteristics and preoperative Tg Ab and TPOAb levels have good discrimination and accuracy,which can help physicians to make individualized clinical decisions.