The Department of General Surgery, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
Department of Ultrasonography, Yuhang Third People's Hospital, Hangzhou, China.
Endocr Pract. 2023 Jun;29(6):428-435. doi: 10.1016/j.eprac.2023.03.275. Epub 2023 Mar 31.
To develop and validate a risk stratification system for the prediction of malignancy in partially cystic thyroid nodules (PCTNs).
We retrospectively reviewed the sonography data of patients with PCTNs from 2 medical centers-Hangzhou Traditional Chinese Medicine Hospital and Hangzhou First People's Hospital-from January 2020 to December 2021. The independent risk factors for malignant PCTNs were evaluated using the univariate and multivariate logistic regression analyses. The nomogram prediction efficiency was assessed using the area under the curve and calibration curves. The decision curve analysis was used to determine the clinical value of the predictive model.
A total of 285 patients were enrolled in this retrospective study, and of 301 PCTNs, 242 were benign and 59 were malignant. Younger age, hypoechoic, irregular margin, and microcalcifications were found to be the independent risk factors for malignant PCTNs. The area under the curve, sensitivity, and specificity were 0.860, 77.1%, and 84.7% in the training data set and 0.897, 91.7%, and 87.0% in the external validation data set, respectively. The total point of nomogram was >161, which showed the best to predict malignancy in PCTNs.
Our findings demonstrated that the risk stratification system for the assessment of PCTNs showed good prediction capacities.
开发并验证一种用于预测部分囊性甲状腺结节（PCTNs）恶性肿瘤风险的分层系统。
我们回顾性分析了 2020 年 1 月至 2021 年 12 月期间来自杭州中医医院和杭州市第一人民医院的 2 家医学中心的 PCTNs 患者的超声数据。使用单因素和多因素逻辑回归分析评估恶性 PCTNs 的独立危险因素。通过曲线下面积和校准曲线评估列线图预测效率。通过决策曲线分析确定预测模型的临床价值。
共有 285 名患者被纳入本回顾性研究，在 301 个 PCTNs 中，242 个为良性，59 个为恶性。结果发现，年龄较小、低回声、不规则边界和微钙化是恶性 PCTNs 的独立危险因素。在训练数据集和外部验证数据集中，曲线下面积、敏感性和特异性分别为 0.860、77.1%和 84.7%，0.897、91.7%和 87.0%。列线图总分>161 时，对预测 PCTNs 恶性肿瘤的效果最佳。
我们的研究结果表明，用于评估 PCTNs 的风险分层系统具有良好的预测能力。
