Department of Thyroid and Breast Surgery, Ningbo First Hospital, Ningbo, China.
School of Medicine, Ningbo University, Ningbo, China.
Front Endocrinol (Lausanne). 2022 Mar 10;13:843573. doi: 10.3389/fendo.2022.843573. eCollection 2022.
The aim of this study is to build a risk assessment system for central lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC) of stage cN0 and to explore its application value in clinical practice.
A total of 500 patients with PTMC who underwent thyroid operation from 2013 to 2015 in Ningbo First Hospital were selected as the model group. Independent risk factors related to CLNM in PTMC were analyzed and determined, and a risk assessment system for CLNM was preliminarily established. Furthermore, the clinicopathological data from 328 PTMC patients with the same conditions as the model group from 2016 to 2017 were further collected as the validation group to verify the diagnostic value of the risk assessment system.
The risk assessment system was based on the score rating (score ≤ 5 was classified as low risk, 6-8 was classified as medium risk, and ≥9 was classified as high-risk). The area under the receiver operating characteristic curve (ROC) was 0.687 (95% CI: 0.635-0.783). According to the risk assessment system, 328 PTMC patients in the validation group were scored. Among the low-risk group, the moderate-risk group, and the high-group, 96.8%, 58.1%, and 43.2% were the CLNM (-) patients, and 3.1%, 41.9%, and 65.8% were CLNM (+) patients, respectively. The area under ROC was 0.837 (95% CI: 0.778-0.869).
The risk assessment system in this study is of diagnostic value and can provide a theoretical foundation for intraoperative decision-making of prophylactic central neck dissection (pCND).
本研究旨在建立 cN0 期甲状腺微小乳头状癌（PTMC）中央区淋巴结转移（CLNM）风险评估系统，并探讨其在临床实践中的应用价值。
选择 2013 年至 2015 年在宁波市第一医院行甲状腺手术的 500 例 PTMC 患者为模型组，分析并确定与 PTMC 患者 CLNM 相关的独立危险因素，并初步建立 CLNM 风险评估系统。进一步收集 2016 年至 2017 年与模型组条件相同的 328 例 PTMC 患者的临床病理资料作为验证组，验证风险评估系统的诊断价值。
该风险评估系统基于评分评级（评分≤5 分为低危，6-8 分为中危，≥9 分为高危）。受试者工作特征曲线（ROC）下面积为 0.687（95%置信区间：0.635-0.783）。根据风险评估系统，对验证组 328 例 PTMC 患者进行评分。在低危组、中危组和高危组中，CLNM（-）患者分别为 96.8%、58.1%和 43.2%，CLNM（+）患者分别为 3.1%、41.9%和 65.8%。ROC 曲线下面积为 0.837（95%置信区间：0.778-0.869）。
本研究的风险评估系统具有诊断价值，可为预防性中央颈清扫术（pCND）的术中决策提供理论依据。
