Objective:

A nomogram prediction model was established to predict the risk of central lymph node metastasis (CLNM) of the neck in patients with papillary carcinoma of the thyroid (PTC) before surgery

so as to reduce the risk of postoperative complications and achieve the purpose of precise treatment.

Methods:

A total of 364 patie

nts with PTC were selected as the research objects

and they were divided into groups according to the pathological results of the central lymph nodes after operation. The general clinical data and ultrasound data of patients were collected

and the factors were selected by using the least absolute shrinkage and selection operator (LASSO) regression. Multivariate logistic regression was used to screen independent influencing factors of CLNM. Then a nomogram model was established to predict the risk of CLNM

and the application value of nomogram through internal validation was evaluated.

Results:

Age ＜45 years old

nodule anteroposterior diameter over 1 cm

irregular nodule shape

multiple lesions

and suspicious lymph nodes detected by ultrasound were the independent influencing factors of CLNM in PTC patients (P＜0.05). The CLNM risk nomogram prediction model showed good discrimination and calibration in internal validation

and its accuracy (0.730

95% CI 0.681-0.775) was better than preoperative cervical lymph node ultrasound (0.638

95% CI 0.586- 0.688) significantly increased (P＜0.001).

Conclusion:

The nomogram established based on clinical and ultrasound features can realize preoperative prediction of CLNM in PTC patients

and is expected to provide guidance for clinical treatment plan.