Please wait a minute...
文章检索
预防医学  2023, Vol. 35 Issue (3): 229-234    DOI: 10.19485/j.cnki.issn2096-5087.2023.03.010
  疾病控制 本期目录 | 过刊浏览 | 高级检索 |
甲状腺乳头状癌中央区淋巴结转移预测模型研究
高梦阳1, 娄鹏威2, 马丽2, 李惠2, 黄玉婷2, 王璐1, 王凯3
1.新疆医科大学公共卫生学院,新疆 乌鲁木齐 830011;
2.新疆医科大学附属中医医院,新疆 乌鲁木齐 830002;
3.新疆医科大学,新疆 乌鲁木齐 830011
A nomograph model for prediction of central lymph node metastasis of papillary thyroid carcinoma
GAO Mengyang1, LOU Pengwei2, MA Li2, LI Hui2, HUANG Yuting2, WANG Lu1, WANG Kai3
1. School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang 830011, China;
2. Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830002, China;
3. Xinjiang Medical University, Urumqi, Xinjiang 830011, China
全文: PDF(939 KB)  
输出: BibTeX | EndNote (RIS)      
摘要 目的 建立甲状腺乳头状癌(PTC)患者颈部中央区淋巴结转移(CLNM)的列线图模型,为制定PTC个性化治疗方案提供依据。方法 收集2018—2021年在新疆医科大学附属中医医院行甲状腺手术治疗且术后病理诊断为PTC的患者资料,以2018—2020年患者资料为训练集,2021年患者资料为验证集。采用多因素logistic回归模型筛选预测因子,建立CLNM风险预测列线图模型;采用受试者操作特征曲线(ROC曲线)和校正曲线评估模型的预测效果。结果 纳入训练集1 820例,CLNM 458例,占25.16%;验证集797例,CLNM 207例,占25.98%。预测模型为p=ey/(1+ey),y=0.761+0.525×性别+(-0.039)×年龄+0.351×腺外侵犯+0.368×颈部淋巴结肿大+1.021×肿瘤最大径+(-0.009)×TT4+(-0.001)×anti-TPOAb。训练集和验证集ROC曲线下面积分别为0.732和0.731;Hosmer-Lemeshow检验显示拟合效果较好(P=0.936、0.722)。结论 本研究构建的列线图模型对PTC患者CLNM具有较好的预测效果。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
高梦阳
娄鹏威
马丽
李惠
黄玉婷
王璐
王凯
关键词 甲状腺乳头状癌中央区淋巴结转移列线图模型风险预测    
AbstractObjective To establish a nomograph model for prediction of cervical central lymph node metastasis (CLNM) among patients with thyroid papillary carcinoma (PTC), so as to provide the evidence for designing personalized treatment plans for PTC. Methods The data of patients that underwent thyroidectomy and were pathologically diagnosed with PTC post-surgery in the Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University from 2018 to 2021 were collected. Patients' data captured from 2018 to 2020 and from 2021 were used as the training set and the validation set, respectively. Predictive factors were screened using a multivariable logistic regression model, and the nomograph model for prediction of CLNM risk was established. The predictive value of the model was evaluated using the receiver operating characteristic (ROC) curve and the adjusted curve. Results Totally 1 820 PTC cases were included in the training set, including 458 cases with CLNM (25.16%), and 797 cases in the validation set, including 207 cases with CLNM (25.98%). The prediction model is p=ey/(1+ey), y=0.761 + 0.525 × sex + (-0.039) ×age + 0.351 × extrathyroid invasion + 0.368 × neck lymph node enlargement + 1.021×maximum tumor diameter + (-0.009) × TT4 + (-0.001) × anti-TPOAb. The area under the ROC curve was 0.732 for the training set and 0.731 for the validation set, and Hosmer-Lemeshow test showed a good fitting effect (P=0.936, 0.722). Conclusion The nomograph model constructed in this study has a high predictive value for CLNM among patients with PTC.
Key wordspapillary thyroid carcinoma    central lymph node metastasis    nomograph model    risk prediction
收稿日期: 2022-09-26      修回日期: 2023-01-13      出版日期: 2023-03-10
中图分类号:  R736.1  
基金资助:自治区创新环境建设专项“天山创新团队计划”(2020D14020)
作者简介: 高梦阳,硕士研究生在读
通信作者: 王凯,E-mail:wangkaimath@sina.com   
引用本文:   
高梦阳, 娄鹏威, 马丽, 李惠, 黄玉婷, 王璐, 王凯. 甲状腺乳头状癌中央区淋巴结转移预测模型研究[J]. 预防医学, 2023, 35(3): 229-234.
GAO Mengyang, LOU Pengwei, MA Li, LI Hui, HUANG Yuting, WANG Lu, WANG Kai. A nomograph model for prediction of central lymph node metastasis of papillary thyroid carcinoma. Preventive Medicine, 2023, 35(3): 229-234.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2023.03.010      或      http://www.zjyfyxzz.com/CN/Y2023/V35/I3/229
[1] FERLAY J,COLOMBET M,SOERJOMATARAM I,et al.Estimating the global cancer incidence and mortality in 2018:GLOBOCAN sources and methods[J].Int J Cancer,2019,144(8):1941-1953.
[2] KEBEBEW E,CLARK O H.Differentiated thyroid cancer:"complete" rational approach[J].World J Surg,2000,24(8):942-951.
[3] 张俐娜,凌煜玮,李开富,等.基于SEER数据库构建的甲状腺微小乳头状癌颈淋巴结转移预测模型的术前应用价值[J].中国普外基础与临床杂志,2022,29(2):188-195.
[4] 许思哲,贺功建,曾黎,等.超声联合肿瘤标记物对cN0期甲状腺微小乳头状癌中央区淋巴结隐匿性转移的预测价值[J].中华普外科手术学杂志(电子版),2021,15(3):314-318.
[5] YAN Y,WANG Y,LIU N,et al.Predictive value of the Delphian lymph node in cervical lymph node metastasis of papillary thyroid carcinoma[J].Eur J Surg Oncol,2021,47(7):1727-1733.
[6] CARVALHO G M C,LEITE T T,LIBORIO A B.Prediction of 60-day case fatality in critically ill patients receiving renal replacement therapy:external validation of a prediction model[J].Shock,2018,50(2):156-161.
[7] 高明. 甲状腺结节和分化型甲状腺癌诊治指南[J].中国肿瘤临床,2012,39(17):1249-1272.
[8] 汤靖岚,侯春杰,范小明.甲状腺微小乳头状癌中央区淋巴结转移的术前超声预测模型建立[J].中华医学超声杂志(电子版),2019,16(4):257-263.
[9] FENG Y,MIN Y,CHEN H,et al.Construction and validation of a nomogram for predicting cervical lymph node metastasis in classic papillary thyroid carcinoma[J].J Endocrinol Invest,2021,44(10):2203-2211.
[10] SHUAI Y J,YUE K,DUAN Y S,et al.Surgical extent of central lymph node dissection for papillary thyroid carcinoma located in the isthmus:a propensity scoring matched study[J/OL].Front Endocrinol,2021,12[2023-01-13].https://doi.org/10.3389/fendo.2021.620147.
[11] LI Y,PIAO J,LI M.Secular trends in the epidemiologic patterns of thyroid cancer in China over three decades:an updated systematic analysis of global burden of disease study 2019 data[J/OL].Front Endocrinol,2021,12[2023-01-13].https://doi.org/10.3389/fendo.2021.707233.
[12] YAO R,CHIU C G,STRUGNELL S S,et al.Gender differences in thyroid cancer:a critical review[J].Expert Rev Endocrinol Metab,2011,6(2):215-243.
[13] ZHANG X S,ZHANG X,LIU M L,et al.Global,regional,and national burden of cirrhosis and other chronic liver diseases due to alcohol use,1990-2019:a systematic analysis for the Global Burden of Disease Study 2019[J/OL].BMC Gastroenterol,2022,22[2023-01-13].https://doi.org/10.1186/s12876-022-02518-0.
[14] XIANG D,XIE L,XU Y,et al.Papillary thyroid microcarcinomas located at the middle part of the middle third of the thyroid gland correlates with the presence of neck metastasis[J].Surgery,2015,157(3):526-533.
[15] 孙庆贺,李小毅,商中华.甲状腺微小乳头状癌淋巴结转移危险因素的研究进展[J].癌症进展,2016,14(1):46-49,55.
[16] LEE H S,PARK C,KIM S W,et al.Correlation of minimal extrathyroidal extension with pathologic features of lymph node metastasis in patients with papillary thyroid carcinoma[J].J Surg Oncol,2015,112(6):592-596.
[17] MOHAMED H E,MOHAMED S E,ANWAR M A,et al.The significance of enlarged cervical lymph nodes in diagnosing thyroid cancer[J].J Cancer Res Ther,2016,12(2):1006-1009.
[18] 孙俪支,凌丰宇,郑泰浩,等.超声弹性成像联合血清TSH、TT3、TT4在甲状腺结节良恶性诊断的临床价值研究[J].现代生物医学进展,2021,21(5):941-944.
[19] 胡晓萌,乔宇,韩朵兰,等.甲状腺乳头状癌颈部淋巴结转移的危险因素[J].中国肿瘤临床,2019,46(11):557-561.
[1] 曹星月, 方海生, 李霄, 沈美萍, 武晓泓. 114例甲状腺乳头状癌亚型体细胞基因突变与TCGA数据库比较分析[J]. 预防医学, 2023, 35(2): 99-103.
[2] 余鸽, 娄乐, 徐方忠. 记忆任务指标评估抑郁障碍风险研究[J]. 预防医学, 2022, 34(7): 687-691.
[3] 买哈巴·木合塔尔, 古丽达娜·塔布斯别克, 马晓薇, 李宏昀, 江志红, 黎飞海, 吴军. 砷和雌激素水平与甲状腺乳头状癌的关联研究[J]. 预防医学, 2022, 34(6): 577-580.
[4] 苏银霞, 卢耀勤, 田翔华, 李莉, 姚华. 基于常规体检指标的2型糖尿病风险预测研究进展[J]. 预防医学, 2022, 34(12): 1230-1234.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed