基于超声及临床特征的列线图在预测甲状腺髓样癌颈部淋巴结转移中的应用价值  

Application Value of Nomogram Model Based on Ultrasonic and Clinical Features in Predicting Cervical Lymph Node Metastasis in Medullary Thyroid Carcinoma

作　　者：张文鑫 刘群[1] 李现艳 李鑫焱 丁玉双 孙芳[1] Zhang Wenxin;Liu Qun;Li Xianyan;Li Xinyan;Ding Yushuang;Sun Fang(Department of Ultrasound,Binzhou Medical University Hospital,Binzhou,Shandong 256603,China;Binzhou Maternal and Child Health Hospital,Binzhou,Shandong 256600,China)

机构地区：[1]滨州医学院附属医院超声医学科,山东省滨州市256603 [2]滨州市妇幼保健院,山东省滨州市256600

出　　处：《中国超声医学杂志》2024年第4期366-369,共4页Chinese Journal of Ultrasound in Medicine

基　　金：山东省自然科学基金(No.ZR2023MH348)。

摘　　要：目的探讨基于超声及临床特征构建的列线图在预测甲状腺髓样癌(MTC)颈部淋巴结转移(CLNM)中的价值。方法回顾性纳入84例MTC患者,分析患者的临床及超声特征,筛选MTC-CLNM的独立预测变量,并以此绘制列线图。计算受试者工作特征(ROC)曲线下面积AUC评估模型预测性能。应用自助法(bootstrap)迭代1000次后计算平均AUC,对模型进行内部验证。结果被膜侵犯、术前降钙素(Ctn)水平和超声提示可疑异常淋巴结为MTC-CLNM的独立预测变量。基于上述变量绘制列线图,AUC为0.851。应用Bootstrap对模型进行内部验证,平均AUC为0.843,模型稳定性良好。结论基于超声及临床特征构建的列线图在术前预测MTC-CLNM状态方面具有一定的价值。Objective To explore the value of a nomogram constructed based on ultrasound and clinical features in predicting cervical lymph node metastasis(CLNM)in patients with medullary thyroid carcinoma(MTC).Methods A retrospective study including 84 patients with MTC was performed.The ultrasonic and clinical features were analyzed to identify independent predictive variables for CLNM in MTC,which were used to construct a nomogram.The area under the receiver operating characteristic(ROC)curve was calculated to assess the predictive performance of the model.Bootstrap with 1000 iterations was used to calculate the average AUC for internal validation of the model.Results Capsular invasion,preoperative calcitonin(Ctn)levels,and ultrasonographic suspicion of abnormal lymph nodes were independent predictive factors for CLNM in MTC.A nomogram was created based on these variables,with an AUC of 0.851.The model was internally validated using the Bootstrap,resulting in an average AUC of 0.843,indicating good model stability.Conclusions The nomogram constructed based on ultrasonic and clinical features has some value in preoperatively predicting the status of CLNM in patients with MTC.

关 键 词：甲状腺髓样癌 颈部淋巴结转移 列线图 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]