Construction of a nomogram model based on clinicopathological features for predicting delphian lymph node metastasis of papillary thyroid carcinoma

FAN Rui; HE Xing-yun; DU Jun-ze; CHEN Lin-li

doi:10.11659/jjssx.01E026014

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Construction of a nomogram model based on clinicopathological features for predicting delphian lymph node metastasis of papillary thyroid carcinoma

Precise Diagnosis and Treatment of Breast and Thyroid Diseases | 更新时间：2026-10-26

- Construction of a nomogram model based on clinicopathological features for predicting delphian lymph node metastasis of papillary thyroid carcinoma
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 10, Pages: 854-859(2026)
- 作者机构：
  
  1.重庆医科大学附属第二医院放射科，重庆400010
  2.陆军军医大学第一附属医院放射科，重庆400038
  3.陆军军医大学第一附属医院乳腺甲状腺外科，重庆400038
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.01E026014
  CLC： R736.1
- Received：05 January 2026，
  
  Revised：2026-09-16，
  
  Accepted：28 April 2026，
  
  Published：25 October 2026
- 稿件说明：
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范锐,贺星云,杜俊泽等.基于临床病理特征预测甲状腺乳头状癌喉前淋巴结转移的列线图模型构建[J].局解手术学杂志,2026,35(10):854-859.

FAN Rui,HE Xing-yun,DU Jun-ze,et al.Construction of a nomogram model based on clinicopathological features for predicting delphian lymph node metastasis of papillary thyroid carcinoma[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):854-859.
范锐,贺星云,杜俊泽等.基于临床病理特征预测甲状腺乳头状癌喉前淋巴结转移的列线图模型构建[J].局解手术学杂志,2026,35(10):854-859. DOI： 10.11659/jjssx.01E026014.

FAN Rui,HE Xing-yun,DU Jun-ze,et al.Construction of a nomogram model based on clinicopathological features for predicting delphian lymph node metastasis of papillary thyroid carcinoma[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):854-859. DOI： 10.11659/jjssx.01E026014.

摘要

目的

基于临床诊疗中易获取的临床病理特征，筛选甲状腺乳头状癌(PTC)患者喉前淋巴结转移的独立危险因素，并构建及验证列线图预测模型，为术前风险分层和个体化手术决策提供参考。

方法

回顾性分析271例PTC患者的临床资料，按7∶3的比例随机分为训练集(

=189)和验证集(

=82)。收集患者临床资料，采用单因素和多因素Logistic回归分析筛选喉前淋巴结转移的独立危险因素，构建列线图预测模型。通过受试者工作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)分别评估模型的区分度、校准度和临床实用性。

结果

多因素Logistic回归分析显示，肿瘤位于中份、多发PTC、中央区淋巴结转移和男性是喉前淋巴结转移的独立危险因素。基于上述独立危险因素构建的列线图模型在训练集和验证集中的曲线下面积（AUC）分别为0.866(95%

:0.815~0.917)和0.833(95%

:0.746~0.919)，显示出良好的区分度。校准曲线显示模型预测概率与实际概率具有良好的一致性，DCA证实该模型具有较高的临床净收益。

结论

肿瘤位于中份、多发PTC、中央区淋巴结转移和男性是PTC患者喉前淋巴结转移的独立危险因素。基于以上因素构建的列线图模型能够有效预测PTC患者喉前淋巴结转移风险，可为临床个体化治疗决策提供参考依据。

Abstract

Objective

To screen the independent risk factors for delphian lymph node metastasis in patients with papillary thyroid carcinoma（PTC） based on readily available clinicopathological characteristics in daily clinical practice，and a nomogram prediction model was constructed and verified to provide references for preoperative risk stratification and individualized surgical decisions.

Methods

A retrospective analysis was conducted on the clinicopathological data of 271 PTC patients. All participants were randomly divided into the training set（

=189） and the validation set（

=82） at a 7∶3 ratio. The clinical data of patients were collected. Univariate and multivariate Logistic regression analyses were used to identify the independent risk factors for delphian lymph node metastasis，and a nomogram prediction model was established. Receiver operating characteristic（ROC） curve，calibration curve and decision curve analysis（DCA） were applied to evaluate the discrimination，calibration and clinical applicability of the model，respectively.

Results

Multivariate Logistic regression analysis revealed that tumor location in the middle，multifocal PTC，central lymph node metastasis and male gender were the independent risk factors for delphian lymph node metastasis. The area under the curve（AUC） of the nomogram model constructed based on the above independent risk factors was 0.866（95%

： 0.815 to 0.917） in the training set and 0.833（95%

： 0.746 to 0.919） in the validation set，suggesting good discriminatory ability. Calibration curves showed good consistency between model-predicted probability and actual incidence. DCA confirmed that the model possessed favorable clinical net benefit.

Conclusion

Tumor location in the middle， multifocal PTC，central lymph node metastasis and male gender are the independent risk factors for delphian lymph node metastasis in patients with PTC. The nomogram model constructed based on the above factors can effectively predict the risk of delphian lymph node metastasis in patients with PTC and provide a reference basis for individualized clinical treatment decisions.

关键词

Keywords

references

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