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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1349853
This article is part of the Research Topic Advances in precision medicine in the management of thyroid nodules and thyroid cancer View all 23 articles

A practical nomogram for preoperatively predicting lateral cervical lymph node metastasis in medullary thyroid carcinoma: A dual-center retrospective study

Provisionally accepted
Jialin Zhu Jialin Zhu 1,2,3Tiantian Guo Tiantian Guo 1,2,3Shuyue Guo Shuyue Guo 1,2,3Luchen Chang Luchen Chang 1,2,3Jing Zhao Jing Zhao 1,2,3Xiaoqing Wang Xiaoqing Wang 1,2,3Xi Wei Xi Wei 1,2,3*
  • 1 Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, Tianjin, Tianjin, China
  • 2 National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, Tianjin Municipality, China
  • 3 Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China

The final, formatted version of the article will be published soon.

    Purpose: Lateral lymph node metastasis (LLNM) is very common in medullary thyroid carcinoma (MTC), but there is still controversy about how to manage cervical lateral lymph nodes, especially for clinically negative MTC. The aim of this study is to develop and validate a nomogram for predicting LLNM risk in MTC.: A total of 234 patients from two hospitals were retrospectively enrolled in this study and divided into LLNM positive group and LLNM negative group based on the pathology. The correlation between LLNM and preoperative clinical and ultrasound variables were evaluated by univariable and multivariable logistic regression analysis. A nomogram was generated to predict the risk of the LLNM of MTC patients, validated by external dataset, and evaluated in terms of discrimination, calibration, and clinical usefulness. Results: The training, internal, and external validation datasets included 152, 51, and 31 MTC patients, respectively. According to the multivariable logistic regression analysis, gender (male), relationship to thyroid capsule and serum calcitonin were independently associated with LLNM in the training dataset. The predictive nomogram model developed with the aforementioned variables showed favorable performance in estimating risk of LLNM, with the area under the ROC curve (AUC) of 0.826 in the training dataset, 0.816 in the internal validation dataset, and 0.846 in the external validation dataset.We developed and validated a model named MTC nomogram, utilizing available preoperative variables to predict the probability of LLNM in patients with MTC. This nomogram will be of great value for guiding the clinical diagnosis and treatment process of MTC patients.

    Keywords: nomogram, medullary thyroid carcinoma, metastasis, Ultrasonography, prediction

    Received: 05 Dec 2023; Accepted: 10 Jul 2024.

    Copyright: © 2024 Zhu, Guo, Guo, Chang, Zhao, Wang and Wei. 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: Xi Wei, Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300070, Tianjin, 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.