摘要
目的分析基于超声特征的甲状腺乳头状癌中央区淋巴结转移(CLNM)的危险因素,构建并验证列线图模型。方法回顾性分析2020年3月至2022年1月福建省肿瘤医院收治的甲状腺癌患者525例,采用单因素分析和Logistic回归分析CLNM的高危因素,使用R软件建立CLNM的列线图模型,运用受试者工作特征曲线(ROC)、校正曲线、决策曲线对模型进行验证。结果年龄、性别、肿瘤大小、甲状腺包膜受累、超声CLNM状态是CLNM的独立危险因素。建立的列线图模型ROC曲线下面积(95%CI)为0.71(0.66,0.76),Hosmer-Lemeshow检验示拟合优度良好(χ2=6.79,P=0.559),校正曲线表明预测值和实际值一致性良好,决策曲线显示模型的净获益较好。结论基于超声特征和临床危险因素建立的列线图模型有效评估甲状腺乳头状癌术前CLNM的发生概率,为临床决策提供重要的参考。
Objective To analyze the risk factors of central lymph node metastasis(CLNM)in papillary thyroid carcinoma based on ultrasound features,and to construct and validate a nomogram model.Methods A retrospective analysis of 525 patients with thyroid cancer admitted to Fujian Cancer Hospital from March 2020 to January 2022 was performed.Univariate analysis and Logistic regression were used to analyze the high-risk factors of CLNM.R software was used to establish a nomogram model of CLNM.Receiver operator characteristic curve(ROC),calibration curve and decision curve were used to validate the model.Results Age,gender,tumor size,thyroid capsule involvement,and ultrasound CLNM status were independent risk factors for CLNM.The area under the ROC curve(95%CI)of the established nomogram model is 0.711(0.664,0.759),and the Hosmer-Lemeshow test shows good goodness of fit(χ2=6.79,P=0.559).The calibration curve shows that the predicted value is in good agreement with the actual value.The decision curve shows that the net benefit of the model is better.Conclusion The nomogram model established based on ultrasound characteristics and clinical risk factors can effectively evaluate the incidence of CLNM in papillary thyroid carcinoma before surgery,and provide an important reference for clinical decision-making.
作者
齐琴
陈巧玲
石灵芳
Qi Qin;Chen Qiaoling;Shi Lingfang(Department of Ultrasound,Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital,Fuzhou 350014,China)
出处
《山西医药杂志》
CAS
2023年第5期332-336,共5页
Shanxi Medical Journal
