中国耳鼻咽喉头颈外科2025，Vol.32Issue(9)：545-550,6.DOI:10.16066/j.1672-7002.2025.09.001
儿童青少年分化型甲状腺癌的淋巴结转移:一项基于多中心数据的预测模型
Lymph nodes metastasis in pediatric patients with differentiated thyroid cancers:a prediction model based on multi-center data
摘要
Abstract
OBJECTIVE To analysis the clinical and pathological characteristics of lymph nodes metastasis in pediatric patients with differentied thyroid carcinoma(pDTC),and to develop a nomogram for predicting lymph nodes metastasis in patients with pDTC.METHODS Four cohorts were integrated in this study,including internal training cohort(1419 cases)and validation cohort(609 cases)from the Surveillance,Epidemiology,and End Results(SEER)database of the National Cancer Institute,TCGA-pDTC cohort(20 cases from the Cancer Genome Atlas Program)and YHD-pDTC cohort(39 cases from true world).The least absolute shrinkage and selection operator(Lasso)and logistic regression were used to screen factors related to lymph nodes metastasis in the presence and exclusion of T stage in pDTCs based on internal training cohort and construct nomograms.Calibration curve,receiver operating characteristic(ROC)curve,area under the ROC curve(AUC)and decision curve analysis(DCA)were used to evaluate model performance in the other three cohorts.RESULTS Multivariate logistic regression results showed that pathology[OR(95%CI):0.020(0.010-0.060),P<0.001],M stage[OR(95%CI):29.550(3.190-273.490),P=0.003],and T stage[OR(95%CI):2.210(1.820-2.680),P<0.001]were independent factors affecting lymph nodes metastasis in pDTCs.Through the internal training set,internal validation set,YHD-pDTC cohort and TCGA-pDTC cohort,the AUC values were 0.734(0.709,0.758),0.752(0.716,0.788),0.969(0.920,1),and 0.600(0.342,0.858)in that order,and the calibration curves are close to the perfect reference line.T stage is a better predictor of lymph nodes metastasis than extraperitoneal intrusion and tumor size.CONCLUSION Pathology,M stage,and T stage are risk factors for predicting lymph nodes metastasis in pDTCs.The nomogram established on this basis can make individualized predictions of the probability of lymph nodes metastasis in pDTCs.关键词
甲状腺肿瘤/青少年分化型甲状腺癌/列线图/淋巴结转移Key words
Thyroid Neoplasms/pediatric differentied thyroid carcinoma/Nomograms/lymph nodes metastasis引用本文复制引用
姚依松,陈曦,李东宪,王海廷,李玉梅,宋西成..儿童青少年分化型甲状腺癌的淋巴结转移:一项基于多中心数据的预测模型[J].中国耳鼻咽喉头颈外科,2025,32(9):545-550,6.基金项目
泰山学者项目(ts20190991) （ts20190991）
山东省重点研发计划(2022CXPT023) （2022CXPT023）
