The Value Of Preoperative NLR And TSH In Predicting The Risk Of Lymph Node Metastasis In The Lateral Region Of Papillary Thyroid Cancer

Objective: To investigate the value of preoperative neutrophil-to-lymphocyte ratio(NLR)and thyroid-stimulating hormone(TSH)in predicting the risk of lymph node metastasis in the lateral neck region in papillary thyroid carcinoma(PTC).Methods:Clinical data were collected from 654 patients with PTC,and cutoff values of continuous variables were obtained by ROC curves.Binary logistic regression analysis was performed,and independent risk factors were included in the logistic regression model to establish a Nomogram.The accuracy and discrimination of the prognostic model were evaluated using c-index and calibration curves.Decision curves were used to predict the potential for clinical application.Results: The comparison between groups revealed that the maximum tumor diameter,number of tumor foci,T stage,NLR,TSH,Tg and Tg\TSH ratio of patients with lymph node metastasis in the lateral neck region and those with lymph node metastasis in the central region of the neck only were statistically significant(P < 0.05);gender,age and Body Mass Index(BMI)were not statistically significant.The results of binary logistic regression one-way analysis showed that the maximum tumor diameter,number of tumor foci,T stage,preoperative NLR,preoperative TSH,preoperative Tg and preoperative Tg\TSH values(all P < 0.05).The results of binary logistic regression multifactor analysis showed that preoperative NLR,TSH,Tg\TSH,T stage,and number of tumor foci(all P < 0.05)were independent risk factors affecting lymph node metastasis in the lateral neck region of PTC patients,and a Nomogram was constructed with a c-index of 0.730,and the model was cross-validated with a c-index of0.719,and its calibration curve had good consistency,and the decision curve indicated good clinical potential.Conclusion: The preoperative NLR low value group and TSH high value group combined with other clinical factors have significant predictive value in predicting lymph node metastasis in the lateral cervical region of papillary thyroid cancer.