[1]方祖瑶,穆维娜.多模态超声联合实验室检查对甲状腺癌颈部淋巴结转移风险的预测研究[J].医学信息,2026,39(02):41-46,62.[doi:10.3969/j.issn.1006-1959.2026.02.007]
　FANG Zuyao,MU Weina.A Study on the Prediction of Cervical Lymph Node Metastasis Risk in Thyroid CancerUsing Multimodal Ultrasound Combined with Laboratory Examination[J].Journal of Medical Information,2026,39(02):41-46,62.[doi:10.3969/j.issn.1006-1959.2026.02.007]
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多模态超声联合实验室检查对甲状腺癌颈部淋巴结转移风险的预测研究()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
39卷
期数:
2026年02期
页码:
41-46,62
栏目:
临床信息学
出版日期:
2026-01-15

文章信息/Info

Title:
A Study on the Prediction of Cervical Lymph Node Metastasis Risk in Thyroid CancerUsing Multimodal Ultrasound Combined with Laboratory Examination
文章编号:
1006-1959（2026）02-0041-07
作者:
方祖瑶1; 穆维娜2
1.承德医学院研究生院，河北 承德 067000；2.保定市第一中心医院超声科，河北 保定 071000
Author(s):
FANG Zuyao1;  MU Weina2
1.Graduate School of Chengde Medical College, Chengde 067000, Hebei, China;2.Department of Ultrasound, Baoding No.1 Central Hospital, Baoding 071000, Hebei, China
关键词:
甲状腺癌; 乳头状癌; 超声; 淋巴结转移; 列线图
Keywords:
Thyroid cancer;  Papilloma;  Ultrasonography;  Lymph node metastasis;  Nomogram
分类号:
R736.1；R445.1
DOI:
10.3969/j.issn.1006-1959.2026.02.007
文献标志码:
A
摘要:
目的 基于术前常规超声、超声造影（CEUS）及剪切波弹性成像（SWE）的多模态超声及实验室检查构建预测甲状腺乳头状癌（PTC）患者颈部淋巴结转移（CLNM）的列线图模型，探讨其临床价值。方法 回顾性分析2021年6月-2023年6月141例于保定市第一中心医院接受多模态超声及临床资料完整的PTC患者，根据手术或穿刺病理结果将其分为CLNM组（67例）与无CLNM组（74例）。比较两组临床资料，将单因素分析中有统计学意义的变量纳入多因素Logistic回归分析，构建列线图模型，以受试者操作特征（ROC）曲线评价模型的预测效能。采用校准曲线及Hosmer-Lemeshow检验评价模型的校准度与拟合优度，临床决策曲线评价其临床适用性，5折交叉验证法分析其稳定性。结果 两组FT4、TPOAb、结节最长径、结节形态、有无被膜侵犯、增强均匀性、增强水平、AUC、Emax比较，差异均有统计学意义（P＜0.05）；多因素Logistic回归分析显示，FT4、结节形态、有无被膜侵犯及Emax为预测PTC患者发生CLNM的独立危险因素（P＜0.05）；AUC为PTC患者发生CLNM的独立保护因素（P＜0.05）。ROC曲线分析显示，该模型预测PTC患者发生CLNM的曲线下面积为0.905；Hosmer-Lemeshow检验及校准曲线显示模型拟合较好（χ2=14.584，P=0.071）；临床决策曲线显示模型临床适用性较好。5折交叉验证法的AUC分别为0.903（95%CI：0.765，1.000）、0.938（95%CI：0.855，1.000)、0.888（95%CI：0.756，1.000）、0.979（95%CI：0.941，1.000）、0.815（95%CI：0.645，0.985），平均AUC为0.905。结论 多模态超声联合实验室检查构建的列线图模型在预测PTC患者CLNM中具有较高的临床价值。
Abstract:
Objective To construct a nomogram model for predicting cervical lymph node metastasis (CLNM) in patients with papillary thyroid carcinoma (PTC) based on preoperative conventional ultrasound, contrast-enhanced ultrasound (CEUS), shear wave elastography (SWE), and laboratory examination, and to explore its clinical value. Methods A retrospective analysis was conducted on 141 PTC patients with complete multimodal ultrasound and clinical data who received multimodal ultrasound at Baoding No.1 Central Hospital. Patients were divided into CLNM group (n=67) and non-CLNM group (n=74) based on surgical or biopsyresults. The clinical data of the two groups were compared. The variables with statistical significance in the univariate analysis were included in the multivariate Logistic regression analysis, and the nomogram model was constructed. The predictive efficacy of the model was evaluated by the receiver operating characteristic (ROC) curve. The calibration curve and Hosmer-Lemeshow test were used to evaluate the calibration and goodness of fit of the model. The clinical decision curve was used to evaluate its clinical applicability, and the 5-fold cross-validation method was used to analyze its stability. Results There were statistically significant differences in FT4, TPOAb, maximum diameter, nodule morphology, presence of capsular invasion, enhancement uniformity, enhancement level, AUC, and Emax between the two groups (P<0.05). Multivariate Logistic regression analysis showed that FT4, nodule morphology, presence of capsular invasion, and Emax were independent risk factors for predicting CLNM in PTC patients (P<0.05); while AUC was an independent protective factor (P<0.05). ROC curve analysis showed that the area under the curve of the model in predicting CLNM of PTC was 0.905. The Hosmer-Lemeshow test and calibration curve showed that the model fitted well (χ2=14.584, P=0.071). The clinical decision-making curve showed good clinical applicability of the model. The AUCs of 5-fold cross-validation were 0.903(95%CI: 0.765, 1.000), 0.938(95%CI: 0.855, 1.000), 0.888(95%CI: 0.756, 1.000), 0.979(95%CI: 0.941, 1.000),0.815(95%CI: 0.645, 0.985), with an average AUC of 0.905. Conclusion The nomogram model based on multimodal ultrasound combined with laboratory examination can effectively predict the probability of CLNM in PTC patients.

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更新日期/Last Update: 1900-01-01