ORIGINAL RESEARCH article
Front. Oncol.
Sec. Molecular and Cellular Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1586307
This article is part of the Research TopicFormation of Immunological Niches in Tumor Microenvironments: Mechanisms and Therapeutic PotentialView all 27 articles
Multifactorial Risk Stratification for Central Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Predictive Model Integrating Clinical and Tumor Characteristics
Provisionally accepted- Department of Head and Neck Surgical Oncology, National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Background: With the increasing prevalence of papillary thyroid carcinoma PTC) and advancements in auxiliary examination technology, the holistic detection rate of malignant thyroid nodules, particularly small ones, continues to rise. However, there remains controversy surrounding the optimal treatment for PTC, and a crucial factor influencing treatment decisions is the status of central lymph node metastasis (CLNM). There is a lack of research on the relationship between clinical laboratory results and tumor characteristics observed during surgery and CLNM status. Therefore, our research aims to systematically explore the risk factor of CLNM in patients with PTC.Methods: We systematically gathered and analyzed clinical features and pathological data of 2,435 PTC patients who underwent surgery. After variable screening, the selected variables were included in logistic regression analysis, and a Nomogram prediction model was constructed according to the analysis results. To investigate the risk factors for CLNM in patients with PTC.Result: This study included a total of 2,435 patients diagnosed with PTC, among whom 933 patients were confirmed as CLNM by postoperative pathology. Univariate and multivariate regression analysis identified age, serum TRAb levels, calcification, multifocality, extrathyroidal invasion, tumor size, and tumor location as risk factors associated with CLNM. The prediction model based on these risk factors demonstrated robust accuracy with an AUC of 0.76. Clinical decision curve analysis indicated that aside from a small range of low threshold probabilities, intervening based on the model’s predictions can yield greater clinical benefit.Conclusion: Key risk factors for CLNM in PTC patients include young age, high serum thyrotropin receptor antibody (TR-Ab) levels, calcification, multifocality, extrathyroidal extension, larger tumor size, and tumor location in the middle or lower poles of the thyroid. The clinical prediction model established based on these critical risk factors can provide a more accurate reference standard for clinical decision-making in practice.
Keywords: Papillary thyroid carcinoma, central lymph node metastasis, Risk factor (RF), Nomo gram, Retrospective study
Received: 02 Mar 2025; Accepted: 28 Apr 2025.
Copyright: © 2025 Yang, wei, qian and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wensheng Liu, Department of Head and Neck Surgical Oncology, National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.