| Popis: |
Background Jugulo-omohyoid lymph nodes (JOHLN) metastasis has proven to be associated with lateral lymph node metastasis (LLNM). This study aimed to reveal the clinical features and evaluate the predictive value of JOHLN in PTC to guide the extent of surgery. This is the first study of the nanogram to predict LLNM using JOHLN. Methods A total of 550 patients pathologically diagnosed with PTC between October 2015 and January 2020, all of whom underwent thyroidectomy and lateral lymph node dissection, were included in this study. Results Thyroiditis, tumor location, tumor size, extra-thyroidal extension, extra-nodal extension, central lymph node metastasis (CLNM) and LLMM were associated with JOHLN. And male, upper lobe tumor, multifocality, extra-nodal extension, CLNM and JOHLN metastasis were independent risk factors from LLNM. A nomogram based on upon predictors performed well. Nerve invasion contributed the most to the prediction model, followed by JOHLN metastasis. The area under the curve (AUC) was 0.855, and the p-value of the Hosmer-Lemeshow goodness of fit test was 0.18. Decision curve analysis showed that the nomogram was clinically helpful. Conclusions JOLHN metastasis could be a clinically sensitive predictor of further LLM, especially the lateral compartment. A high-performance nomogram was established, which can provide an individual risk assessment of LNM and guide treatment decisions for patients. Trial registration: This study was approved by the ethics committee of the Cancer Hospital of Chinese Academy of Medical Sciences (reference number: NCC2016ST-23). |
