A Nomogram based on clinical and ultrasound characteristics to predict central lymph node metastases of papillary thyroid microcarcinoma

Abstract:

Objective: To develop a Nomogram for predicting central lymph node metastases (CLNM) for that the status of central lymph nodes is important for determining the surgical strategy of papillary thyroid microcarcinoma (PTMC) . Methods: PTMC patients who underwent thyroidectomy and central neck dissection in The First People’s Hospital of Changzhou from July 2019 to November 2020 were retrospectively retrieved. These patients were randomly divided into "modeling group" and "validation group" . Univariate and multivariate analyses were performed in the modeling group to determine the risk factors for CLNM. The Nomogram used to predict CLNM was developed and verified internally and externally. Results: Independent risk factors related to CLNM (gender, maximum tumor diameter, number of lesions, aspect ratio, and margin) were included in the Nomogram. The calibration curve showed that the Nomogram was in good agreement with the CLNM prediction of actual clinical observation. The area under the curve of the Nomogram in the modeling group and the verification group were 0.759 and 0.757, respectively. Conclusion: The Nomogram can objectively quantify the possibility of CLNM before surgery. Clinicians can use this model to assess the lymph node status of patients with PTMC and consider prophylactic central neck dissection in high-risk patients.