Abstract
This study aimed to establish a model for predicting lateral neck lymph node metastasis in patients with papillary thyroid carcinoma. A total of 106 patients with papillary thyroid carcinoma undergoing initial treatment of neck lymph node dissection (including central and lateral neck lymph nodes) at the thyroid surgery department were enrolled from January 2009 to April 2017. Logistic regression analysis was used to screen the factors influencing lateral neck lymph node metastasis and develop a prediction model. The receiver operating characteristic curve was used to evaluate the predictive power and boundary value of the model for lateral neck lymph node metastasis. Prediction model: Logistic(P) = −5.699 + 0.681 × (TSH) + 0.342 × (Metastatic rate of central lymph nodes) + 1.463 × (Combined with Hashimoto’s disease) + 1.525 × (Number of tumors). When logistic (P) was ≥ 0.821, it was predicted that lateral neck lymph node metastasis occurred in patients with papillary thyroid carcinoma. When logistic (P) was <0.821, it was predicted that no metastasis was found in the lateral neck lymph node. The prediction accuracy was 78.3%. The model helped in evaluating lateral neck lymph node metastasis in patients with papillary thyroid carcinoma. Also, it had significance in determining reasonable surgical range, reducing unnecessary lateral neck lymph node dissection, and further improving the quality of life of patients.
Highlights
Thyroid cancer, a common malignant tumor of the endocrine system, has become one of the fastest-growing tumors in the world, with the incidence rate increasing year by year[1]
Stage II patients with lymph node risk had a much higher cancer-specific mortality rate (20.9%) than those in the same stage without LN risk (3.2%)[16]. This indicated that an important risk factor for lower survival rate in patients with thyroid cancer is neck lateral lymph node metastasis
Cai et al suggested that central lymph node metastasis in patients with papillary thyroid carcinoma was related to lateral neck metastasis
Summary
A common malignant tumor of the endocrine system, has become one of the fastest-growing tumors in the world, with the incidence rate increasing year by year[1]. Accurate preoperative evaluation of lateral neck lymph node metastasis helps in determining the surgical range and improving tumor-free survival and quality of life of patients. Logistic regression model and receiver operating characteristic (ROC) curve were used to analyze the clinicopathological features of patients with papillary thyroid carcinoma, so as to predict lateral neck lymph node metastasis. It helped in determining the surgical range, further improving the quality of life of patients and reducing recurrence. Index TSH Metastasis rate of central lymph node Thyroid carcinoma combined with Hashimoto’s disease Number of tumors Prediction model
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