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    李佳, 宋杨, 汤铜. 单侧甲状腺乳头状癌中央区淋巴结转移的临床预测模型构建[J]. 蚌埠医科大学学报, 2023, 48(9): 1215-1219. DOI: 10.13898/j.cnki.issn.1000-2200.2023.09.008
    引用本文: 李佳, 宋杨, 汤铜. 单侧甲状腺乳头状癌中央区淋巴结转移的临床预测模型构建[J]. 蚌埠医科大学学报, 2023, 48(9): 1215-1219. DOI: 10.13898/j.cnki.issn.1000-2200.2023.09.008
    shu
    LI Jia, SONG Yang, TANG Tong. Construction of clinical predictive model for central lymph node metastasis of unilateral papillary thyroid carcinoma[J]. Journal of Bengbu Medical University, 2023, 48(9): 1215-1219. DOI: 10.13898/j.cnki.issn.1000-2200.2023.09.008
    Citation: LI Jia, SONG Yang, TANG Tong. Construction of clinical predictive model for central lymph node metastasis of unilateral papillary thyroid carcinoma[J]. Journal of Bengbu Medical University, 2023, 48(9): 1215-1219. DOI: 10.13898/j.cnki.issn.1000-2200.2023.09.008
    shu

    单侧甲状腺乳头状癌中央区淋巴结转移的临床预测模型构建

    Construction of clinical predictive model for central lymph node metastasis of unilateral papillary thyroid carcinoma

      摘要
    • 摘要:
      目的探讨单侧甲状腺乳头状癌(PTC)发生中央区淋巴结转移的相关危险因素并构建临床预测模型，为单侧PTC的预防性中央区淋巴结清扫提供决策依据。
      方法收集183例cN0单侧PTC病人的临床病理资料，分析预防性中央淋巴结清扫术后淋巴结转移的独立危险因素，并构建预测模型，将预测概率和真实值构建ROC曲线，分析该模型对于中央区淋巴结转移的预测效果。
      结果多因素分析结果显示，男性、年龄 < 55岁、肿瘤最大径>1 cm及钙化是中央区淋巴结转移的独立危险因素。依据独立危险因素建立的预测模型：Logit(P)=-1.814+1.105×性别+0.953×年龄+0.707×肿瘤最大径+0.863×钙化形成；ROC曲线下面积为0.716(95%CI：0.641~0.790)。
      结论建立的单侧cN0 PTC中央区淋巴结转移预测模型有较好的预测效果以及实用价值，可在术前使用该模型进行计算中央区淋巴结转移的概率，P值越大则淋巴结转移的风险越高，可进行预防性中央区淋巴结清扫。

       

      Abstract:
      ObjectiveTo explore the risk factors of central lymph node metastasis in unilateral papillary thyroid carcinoma (PTC) and to establish a clinical predictive model to provide decision-making basis for preventive central lymph node dissection in unilateral PTC.
      MethodsThe clinical and pathological data from 183 cN0 unilateral PTC patients were collected.The independent risk factors for lymph node metastasis after preventive central lymph node dissection were analyzed, and a predictive model was constructed.ROC curve based on the predicted probability and true value was constructed, and the predictive effect of the model on lymph node metastasis in the central region was analyzed.
      ResultsMultivariate analysis showed that male, age < 55 years, tumor diameter >1 cm, and calcification were independent risk factors for central lymph node metastasis.Prediction model based on independent risk factors: Logit (P)=-1.814+1.105×gender+0.953×age+0.707×tumor diameter + 0.863×calcification.The area under the ROC curve was 0.716 (95%CI: 0.641-0.790).
      ConclusionsThe prediction model has a good prediction effect and practical value of central lymph node metastasis for unilateral cN0 PTC.The model can be used to calculate the probability of central lymph node metastasis before operation.The higher the P value, the higher the risk of lymph node metastasis, and preventive central lymph node dissection should be performed.

       

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