巴楚医学2025，Vol.8Issue(1)：75-81,7.DOI:10.3969/j.issn.2096-6113.2025.01.014
甲状腺乳头状癌合并桥本甲状腺炎患者发生淋巴结转移的风险预测模型构建
Construction of a Risk Prediction Model for Lymph Node Metastasis in Patients of Papillary Thyroid Carcinoma Combined with Hashimoto's Thyroiditis
摘要
Abstract
Objective:To explore the risk factors for central lymph node metastasis(CLNM)in patients of papillary thyroid carcinoma(PTC)complicated with Hashimoto's thyroiditis(HT)and to construct a predictive model.Methods:A retrospective analysis was conducted on the clinical data of 422 patients with PTC and HT who underwent thyroidectomy and central lymph node dissection at Yichang Central People's Hospital from May 2021 to May 2023.Univariate and multivariate logistic regression analyses were used to assess the independent risk factors for CLNM in patients with PTC and HT,and a risk prediction model was established.Results:The included patients were randomly divided into a model training set(n=295)and a model validation set(n=127)at a ratio of 7∶3,with the training set divided into a non-metastasis group(n=146)and a metastasis group(n=149).Multivariate logistic regression analysis showed that calcification(OR=5.674,95％CI:1.294,24.892),elevated neutrophil-to-lymphocyte ratio(NLR)(OR=6.013,95％CI:2.748,13.158),elevated lymphocyte-to-monocyte ratio(LMR)(OR=3.662,95％CI:1.780,7.534),elevated systemic immune-inflammation index(SII)(OR=1.019,95％CI:1.011,1.027),and elevated thyroid-stimulating hormone(TSH)(OR=2.594,95％CI:1.662,4.048)were all independent risk factors for CLNM in patients with PTC and HT(all P＜0.05).The area under the receiver operating characteristic(ROC)curve for the training set was 0.876,and for the validation set was 0.866.The calibration curve indicated good consistency between the predicted efficiency and the actual situation.Conclusion:Calcification,elevated NLR,elevated LMR,elevated SII,and elevated TSH are all independent risk factors for CLNM in patients with PTC and HT.The Nomogram model constructed in this study has high sensitivity and specificity and is of significant clinical reference value.关键词
甲状腺乳头状癌/桥本氏甲状腺炎/中央区淋巴结转移/炎症因子/列线图模型Key words
papillary thyroid carcinoma(PTC)/Hashimoto's thyroiditis(HT)/central lymph node metastasis(CLNM)/inflammatory factors/Nomogram model分类
临床医学引用本文复制引用
闵楠,艾空,杨新宇,吴登鼎,胡军..甲状腺乳头状癌合并桥本甲状腺炎患者发生淋巴结转移的风险预测模型构建[J].巴楚医学,2025,8(1):75-81,7.基金项目
湖北省卫生健康委员会科研项目(WJ2021M065). （WJ2021M065）
