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

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.