Development and validation of a dynamic nomogram for predicting central lymph node metastasis in papillary thyroid carcinoma patients based on clinical and ultrasound features

作者：Zhe Chen, Jiajia Wang, Juan Du, Jia-Fan Li, Ruo-Ting Zheng, Shu-Min Yuan, Ting Wu, Dongming Guo, Yuxia Zhai · 发表于：Quantitative Imaging in Medicine and Surgery · 年份：2025 · DOI：10.21037/qims-24-618 · 被引用次数：4 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid and Parathyroid Surgery、Endometrial and Cervical Cancer Treatments

Background: Prophylactic cervical lymph node dissection (CLND) for patients with papillary thyroid carcinoma (PTC) has long been a subject of controversy. To accurately perform preoperative staging and risk stratification of PTC patients, this study developed and validated a preoperative nomogram model for predicting central lymph node metastasis (CLNM) based on clinical and ultrasound features, thereby guiding surgical resection and postoperative adjuvant therapy. Methods: Patients with PTC (n=409), as confirmed by surgery and histopathology combined with CLND, were divided into training and validation groups. Clinical information, ultrasound features, American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) scores and Chinese version of the Thyroid Imaging Reporting and Data System (C TI-RADS) scores were collected. The features in the training group were selected by least absolute shrinkage and selection operator (LASSO) regression. These potential features were included in a multivariate logistic regression analysis to identify independent risk factors for CLNM and to develop a dynamic nomogram. In both the training and validation groups, the nomogram was evaluated for discrimination, calibration and clinical utility. Results: It was found that sex, age, multifocality, capsule contact, margin, micro-calcification, and ultrasound-based CLNM status were independent risk factors of CLNM, and a dynamic nomogram was used to develop a prediction mod...