NOMOGRAM FOR PREDICTING LYMPH NODE METASTASIS IN PAPILLARY THYROID MICROCARCINOMA

Jiaqi Luo¹, Zhen Long¹, Zhiwen Xiao¹, Weiping Wen^{1, 2}, Shimin Zhuang¹, Xiaomei Sun¹, Liangen Xie¹, Cuixia Huang¹, Guangyong Tian³, Guanping Zhang^{1, *}, Tianrun Liu^{1, *}

¹Departments of Otolaryngology-Head & Neck Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China - ²Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China - ³The Third Affiliated Hospital of Southern Medical University, Guangzhou, People’s Republic of China

Background: Lymph node metastasis (LNM) is an essential prognostic factor for papillary thyroid microcarcinoma. The objective of the present study was to construct a prediction model and a nomogram to preoperatively predict the probability of LNM.

Materials and methods: The study data were obtained from the Surveillance, Epidemiology, and End Results (SEER) Database. A total of 34,253 eligible patients were enrolled. The LNM risk factors were screened using the chi-squared test and t-test, while the prediction model and the nomogram were established by binary logistic regression analysis, and the nomogram was verified in the validation group.

Results: Regarding papillary thyroid microcarcinoma, our research found that age of diagnosis, gender, race, tumour size, T stage and pathology classification were significantly related to the regional node metastasis of papillary thyroid microcarcinoma. The AUC of the nomogram was 0.768 (95% confidence interval (CI) 0.757 to 0.780) and was validated in the validation set at 0.772 (95% CI 0.761 to 0.782), indicating excellent prediction performance. The slope of the correction curve of each group of data is close to 1, thereby demonstrating excellent calibration of the nomogram.

Conclusion: Factors such as age, race, gender, tumour size, T stage, and pathological subtype have essential effects on the lymph node metastasis of papillary thyroid carcinoma. This study established a nomogram based on clinicopathological parameters that can accurately predict the preoperative status of local lymph nodes and will be helpful for the preoperative evaluation of lymph node metastasis in patients, thereby providing a reference for clinicians to make treatment decisions.