Zhao ShiYi, Yan Wei, Yu Jin, Chen DeJie
College of Medicine, Wuhan University of Science and Technology, Wuhan, China.
Department of Thyroid and Breast Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
Front Endocrinol (Lausanne). 2025 Apr 24;16:1532840. doi: 10.3389/fendo.2025.1532840. eCollection 2025.
This study aims to investigate the risk factors associated with contralateral occult carcinoma in patients with unilateral papillary thyroid carcinoma and to develop a corresponding prediction model to enhance early detection and clinical management of occult carcinoma.
The clinical data of 430 patients who underwent total thyroidectomy for unilateral papillary thyroid carcinoma at Xiangyang Central Hospital between January 2021 and December 2022 were collected. Univariate and multivariate logistic regression analyses were performed to identify risk factors for contralateral occult cancer in patients with unilateral thyroid carcinoma. A prediction model was established, and the diagnostic value of the model was assessed using calibration curves and decision curve analysis.
The results of univariate logistic regression analysis indicated that tumor diameter, tumor location, multifocality, presence of contralateral benign nodules, and lateral neck lymph node metastasis were risk factors for contralateral occult carcinoma in patients with unilateral thyroid cancer (P < 0.05). Multivariate logistic regression analysis further showed that a tumor diameter >1 cm, proximity of the tumor to the isthmus, multifocality, presence of contralateral benign nodules, and lateral neck lymph node metastasis were independent risk factors for contralateral occult carcinoma in unilateral thyroid cancer (P < 0.01). A risk nomogram model was developed based on these five risk factors, with areas under the curve (AUC) of 0.921 and 0.96 for the training and validation sets, respectively. The calibration curve demonstrated good consistency, and decision curve analysis indicated that the model had a high level of net benefit.
A tumor diameter >1 cm, proximity of the tumor to the isthmus, lateral neck lymph node metastasis, presence of contralateral benign nodules, and multifocality are independent risk factors for contralateral occult carcinoma in patients with unilateral papillary thyroid carcinoma. The predictive model developed in this study demonstrates strong predictive ability for the occurrence of contralateral occult carcinoma in patients with unilateral papillary thyroid carcinoma.
本研究旨在探讨单侧甲状腺乳头状癌患者对侧隐匿性癌的相关危险因素，并建立相应的预测模型，以加强隐匿性癌的早期检测和临床管理。
收集2021年1月至2022年12月在襄阳市中心医院因单侧甲状腺乳头状癌行全甲状腺切除术的430例患者的临床资料。进行单因素和多因素logistic回归分析，以确定单侧甲状腺癌患者对侧隐匿性癌的危险因素。建立预测模型，并使用校准曲线和决策曲线分析评估该模型的诊断价值。
单因素logistic回归分析结果表明，肿瘤直径、肿瘤位置、多灶性、对侧良性结节的存在以及侧颈淋巴结转移是单侧甲状腺癌患者对侧隐匿性癌的危险因素（P<0.05）。多因素logistic回归分析进一步显示，肿瘤直径>1 cm、肿瘤靠近峡部、多灶性、对侧良性结节的存在以及侧颈淋巴结转移是单侧甲状腺癌对侧隐匿性癌的独立危险因素（P<0.01）。基于这五个危险因素建立了风险列线图模型，训练集和验证集的曲线下面积（AUC）分别为0.921和0.96。校准曲线显示出良好的一致性，决策曲线分析表明该模型具有较高的净效益水平。
肿瘤直径>1 cm、肿瘤靠近峡部、侧颈淋巴结转移、对侧良性结节的存在以及多灶性是单侧甲状腺乳头状癌患者对侧隐匿性癌的独立危险因素。本研究建立的预测模型对单侧甲状腺乳头状癌患者对侧隐匿性癌的发生具有较强的预测能力。
