基于超声成像和临床特征的儿童和青少年甲状腺乳头状癌侧淋巴结转移预测模型:一项回顾性研究。

IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING BMC Medical Imaging Pub Date : 2024-08-29 DOI:10.1186/s12880-024-01384-4
Shiyang Lin, Yuan Zhong, Yidi Lin, Guangjian Liu
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引用次数: 0

摘要

背景:儿童甲状腺乳头状癌(PTC)患者出现侧淋巴结转移(LNM)是导致复发的独立风险因素。我们旨在确定儿童和青少年 PTC 患者手术前出现侧淋巴结转移的风险因素并建立预测模型:方法:我们根据 2014 年 1 月至 2023 年 6 月期间 63 名患有 PTC 的未成年人的数据建立了一个预测模型。我们收集并分析了患者的临床因素、原发肿瘤的超声(US)特征和病理记录。我们采用多变量逻辑回归分析来确定独立的预测因素并建立预测模型。我们使用接收者操作特征曲线下面积(ROC)评估了风险因素和预测模型的预测性能。我们利用决策曲线分析评估了预测模型的临床实用性:在患有 PTC 的未成年人中,21 人患有侧位 LNM(33.3%)。逻辑回归显示,侧位 LNM 的独立风险因素包括多灶性、肿瘤大小、性别和年龄。多灶性、肿瘤大小、性别和年龄的ROC曲线下面积分别为0.62(P = 0.049)、0.61(P = 0.023)、0.66(P = 0.003)和0.58(P = 0.013)。与单一风险因素相比,组合预测因子的 ROC 曲线下面积(0.842)明显更高,灵敏度和特异度分别为 71.4% 和 81.0%(临界值 = 0.524)。决策曲线分析表明,该预测模型对临床有用,阈值概率介于 2% 和 99% 之间:结论:儿科 PTC 患者患侧 LNM 的独立风险因素是 US 成像显示的多灶性和肿瘤大小,以及性别和年龄。我们的模型在预测侧位 LNM 的情况方面优于单纯的 US 成像和临床特征。
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Prediction model for lateral lymph node metastasis of papillary thyroid carcinoma in children and adolescents based on ultrasound imaging and clinical features: a retrospective study.

Background: The presence of lateral lymph node metastases (LNM) in paediatric patients with papillary thyroid cancer (PTC) is an independent risk factor for recurrence. We aimed to identify risk factors and establish a prediction model for lateral LNM before surgery in children and adolescents with PTC.

Methods: We developed a prediction model based on data obtained from 63 minors with PTC between January 2014 and June 2023. We collected and analysed clinical factors, ultrasound (US) features of the primary tumour, and pathology records of the patients. Multivariate logistic regression analysis was used to determine independent predictors and build a prediction model. We evaluated the predictive performance of risk factors and the prediction model using the area under the receiver operating characteristic (ROC) curve. We assessed the clinical usefulness of the predicting model using decision curve analysis.

Results: Among the minors with PTC, 21 had lateral LNM (33.3%). Logistic regression revealed that independent risk factors for lateral LNM were multifocality, tumour size, sex, and age. The area under the ROC curve for multifocality, tumour size, sex, and age was 0.62 (p = 0.049), 0.61 (p = 0.023), 0.66 (p = 0.003), and 0.58 (p = 0.013), respectively. Compared to a single risk factor, the combined predictors had a significantly higher area under the ROC curve (0.842), with a sensitivity and specificity of 71.4% and 81.0%, respectively (cutoff value = 0.524). Decision curve analysis showed that the prediction model was clinically useful, with threshold probabilities between 2% and 99%.

Conclusions: The independent risk factors for lateral LNM in paediatric PTC patients were multifocality and tumour size on US imaging, as well as sex and age. Our model outperformed US imaging and clinical features alone in predicting the status of lateral LNM.

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来源期刊
BMC Medical Imaging
BMC Medical Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.60
自引率
3.70%
发文量
198
审稿时长
27 weeks
期刊介绍: BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.
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