Obejetive:

To investigate the value of ultrasound in predi

cting the 5-year postoperative recurrence of patients with Hashimoto’s thyroiditis (HT) combined with papillary carcinoma of the thyroid (PTC)

hereinafter referred to as HTPTC

and to establish a prediction model.

Methods:

The ultrasound and clinical data of 292 HTPTC patients treated surgically were collected and analyzed. The recurrence of patients was recorded

with a median follow-up time of 5.42 years. Recurrence was defined as the presence of cancer cells in new lesions or abnormal lymph nodes confirmed by fine-needle aspiration biopsy (FNAB) or pathology results after a second surgery. Univariate Cox regression analysis was used to determine potential predictors related to 5-year recurrence

which were then included in a multivariate Cox regression analysis to identify independent predictors of recurrence and to construct and evaluate a prediction model.

Results:

The multivariate Cox regression analysis confirmed that a nodule maximum diameter greater than 1.5 cm (HR=3.37

95% CI 1.17-9.68

P

=0.023)

a nodule aspect ratio greater than 1 (HR=4.82

95% CI 1.69- 13.75

P

=0.003)

microcalcification (HR=5.51

95% CI 1.18-25.68

P

=0.029)

and multifocal malignant nodules (HR=3.28

95% CI 1.03-10.47

P

=0.045) were independent predictors of 5-year recurrence in HTPTC patients. Using these variables

a prediction model for recurrence in HTPTC patients was established. The C-index of the model was 0.845 (SE=0.061). The area under the receiver operating characteristic (ROC) curve was 0.767 (95% CI 0.502-1.000) for the third year and 0.834 (95% CI 0.695-0.943) for the fifth year.

Conclusion:

The ultrasound-based predictive model provides a new method for assessing the recurrence risk in HTPTC patients

aiding doctors in personalizing preoperative planning for patients to reduce overtreatment.