Bi Jingcheng, Yao Tianqi, Yao Yu, Zhu Zhengcai, Lei Qiucheng, Jiao Lianghe, Li Tao
Department of General Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China.
Department of Hepatopancreatic Surgery/Organ Transplantation Center, The First People's Hospital of Foshan, Foshan, China.
Ann Med. 2025 Dec;57(1):2443564. doi: 10.1080/07853890.2024.2443564. Epub 2024 Dec 27.
To comprehensively investigate the predictive value of thyroid hormone sensitivity parameters for cervical lymph node metastasis in patients diagnosed with differentiated thyroid cancer (DTC) undergoing total thyroidectomy and neck lymph node dissection.
A retrospective cohort study was conducted involving patients diagnosed with DTC and evaluated for cervical lymph node metastasis. Relevant demographic, tumour, lymph node and thyroid hormone sensitivity parameter data were extracted from medical records and laboratory reports. Thyroid hormone sensitivity parameters including thyroxine (T4), triiodothyronine (T3), thyroid-stimulating hormone (TSH), thyroglobulin (Tg), thyroglobulin antibodies (TgAbs), thyroid peroxidase antibody, thyroid hormone receptor α and TSH receptor antibody were assessed. Statistical analyses including descriptive statistics, comparative analysis, Pearson's correlation analysis, logistic regression analysis, receiver operating characteristic (ROC) analysis and construction of a multivariable prediction model based on machine learning using the xgbTree method were employed to evaluate the associations and predictive value of thyroid hormone sensitivity parameters for cervical lymph node metastasis.
The study revealed significant associations between several thyroid hormone sensitivity parameters and cervical lymph node metastasis in patients with DTC. Specifically, higher levels of T4, T3, Tg, TgAbs and TSH receptor antibody were associated with lymph node metastasis. Pearson's correlation analysis, logistic regression analysis and ROC analysis further underscored the predictive performance of these parameters, with strong overall discriminative abilities. The machine learning-based prediction model demonstrated promising performance with a high area under the curve (AUC) of 0.979.
The findings provide compelling evidence for the predictive value of thyroid hormone sensitivity parameters, particularly T3, T4, Tg, TgAbs and TSH receptor antibody, in identifying and evaluating the likelihood of cervical lymph node metastasis in patients with DTC. These parameters hold potential implications for risk stratification, clinical decision-making and personalized management strategies, contributing to improved outcomes for patients at risk of lymph node metastasis.
全面研究甲状腺激素敏感性参数对接受全甲状腺切除术和颈部淋巴结清扫术的分化型甲状腺癌（DTC）患者颈部淋巴结转移的预测价值。
进行一项回顾性队列研究，纳入被诊断为DTC并接受颈部淋巴结转移评估的患者。从病历和实验室报告中提取相关的人口统计学、肿瘤、淋巴结及甲状腺激素敏感性参数数据。评估甲状腺激素敏感性参数，包括甲状腺素（T4）、三碘甲状腺原氨酸（T3）、促甲状腺激素（TSH）、甲状腺球蛋白（Tg）、甲状腺球蛋白抗体（TgAbs）、甲状腺过氧化物酶抗体、甲状腺激素受体α和TSH受体抗体。采用包括描述性统计、比较分析、Pearson相关分析、逻辑回归分析、受试者工作特征（ROC）分析以及使用xgbTree方法基于机器学习构建多变量预测模型等统计分析方法，来评估甲状腺激素敏感性参数与颈部淋巴结转移的关联及预测价值。
该研究揭示了DTC患者中几个甲状腺激素敏感性参数与颈部淋巴结转移之间存在显著关联。具体而言，T4、T3、Tg、TgAbs和TSH受体抗体水平较高与淋巴结转移相关。Pearson相关分析、逻辑回归分析和ROC分析进一步强调了这些参数的预测性能，具有较强的总体判别能力。基于机器学习的预测模型表现出良好的性能，曲线下面积（AUC）高达0.979。
这些发现为甲状腺激素敏感性参数，特别是T3、T4、Tg、TgAbs和TSH受体抗体，在识别和评估DTC患者颈部淋巴结转移可能性方面的预测价值提供了有力证据。这些参数对风险分层、临床决策和个性化管理策略具有潜在意义，有助于改善有淋巴结转移风险患者的治疗效果。
