Evidence map›Paper›PMID 41998526›Full record

ArticleBMC cancer2026

Development of a clinically applicable prediction tool for lymph node metastasis in papillary thyroid carcinoma using lasso-logistic regression.

Wei Zhang, Jichao Zhu, Ying Zhang, Xu Zhang, Ying Dong, Xiao Yu, Yidan Zhang, Kun Wang, Anquan Shang

Abstract read
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Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Wei Zhang *Department of Laboratory Medicine, Affiliated Lianyungang Clinical College of Nantong University, Lianyungang, Jiangsu Province, 222006, China.
Jichao Zhu *Department of Laboratory Medicine, Huzhou Central Hospital, Huzhou, Zhejiang Province, 313000, China.
Ying Zhang *Department of Laboratory Medicine, Affiliated Lianyungang Clinical College of Nantong University, Lianyungang, Jiangsu Province, 222006, China.
Xu Zhang *Department of Laboratory Medicine, Chongming Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, 202150, China.
Ying DongDepartment of Laboratory Medicine, Affiliated Lianyungang Clinical College of Nantong University, Lianyungang, Jiangsu Province, 222006, China.
Xiao YuDepartment of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
Yidan ZhangDepartment of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
Kun WangDepartment of Laboratory Medicine, Affiliated Lianyungang Clinical College of Nantong University, Lianyungang, Jiangsu Province, 222006, China. wangkun@lygey.com.
Anquan ShangDepartment of Laboratory Medicine, Affiliated Lianyungang Clinical College of Nantong University, Lianyungang, Jiangsu Province, 222006, China. shanganquan@tongji.edu.cn.

Funding

iangsu Provincial Health and Health Commission Research Project K2024084, JSZJ20241204the 2024 Lianyungang City Tumor Prevention and Treatment Science and Technology Development Plan Project ZD202403, QN202412, QN202416, QN202418the Anti-Cancer Association Lianyungang City Tumor Prevention and Treatment Project ZD202305the Bengbu Medical University Key Natural Science Project 2024byzd300, 2024byzd303, 2024byzd307the Jiangsu University Medical Education Cooperation Project JDYY2023085the Lianyungang City 521 High-level Talent Training Project LYG065212024074the Lianyungang City Health Science and Technology Project 202321The Project Supported by Science Foundation of Kangda College of Nanjing Medical University KD2024KYJJ036, KD2024KYJJ038, KD2024KYJJ040, KD2024KYJJ044, KD2023KYJJ054
6 · The paper itself

Abstract

objectiveThis study aims to analyze clinical and laboratory data from patients to identify indicators associated with lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC). Furthermore, we aim to develop a nomogram and a web-based calculator for predicting the risk of LNM.

methodsWe conducted a retrospective analysis of 1,134 patients who underwent PTC resection between January 2018 and July 2023. The enrolled patients were randomly divided into a modeling set and a validation set in a 7:3 ratio. Lasso-logistic regression was employed to identify independent predictors of LNM in PTC. The dose-response relationship between independent influencing factors and the risk of PTC occurrence was assessed using restricted cubic spline (RCS). Finally, we evaluated the diagnostic value and clinical net benefit of each indicator using receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

resultsLasso-logistic regression analysis revealed that ultrasound TI-RADS classification, nodule diameter, nodule number, gender, age, APOB, and CEA are independent predictors of LNM in patients with PTC. RCS analysis indicates that nodule diameter, age, CEA, and APOB levels exhibit both linear or nonlinear relationships with the risk of LNM in PTC patients. A nomogram and a web-based calculator were developed to predict the risk of LNM in PTC based on these characteristic variables. The full model's area under the receiver operating characteristic (AUROC) curve is 0.753 (95% CI: 0.716-0.790), with a mean cross-validation AUROC of 0.738 (95% CI: 0.710-0.768) and a pooled cross-validation AUROC of 0.734 (95% CI: 0.696-0.772). The AUROC value for the validation set is 0.733 (95% CI: 0.682-0.779), the prediction model demonstrates moderate discriminative ability. Calibration assessment using calibration plots, slope, intercept, and the Hosmer–Lemeshow test indicated acceptable agreement between predicted and observed risks. DCA demonstrated higher net benefit across clinically relevant thresholds, and the clinical impact curve (CIC) showed good agreement between predicted high-risk patients and observed events. Furthermore, the model has been transformed into a freely accessible web-based calculator (https://ley120.shinyapps.io/Lymph_Node_Metastasis_in_PTC/).

conclusionTI-RADS classification, Nodule diameter, Nodule number, Gender, Age, APOB, and CEA have moderate diagnostic value in evaluating lymph node metastasis of PTC. This study developed a nomogram with acceptable discrimination for predicting LNM risk in PTC, which may assist clinicians in risk stratification when used alongside other clinical assessments. This model serves as a supplementary tool for risk estimation rather than a definitive diagnostic standard.

Indexed as

Lymphatic MetastasisNomogramsThyroid Cancer, PapillaryThyroid NeoplasmsAdultFemaleHumansLogistic ModelsLymph NodesMaleMiddle AgedRetrospective StudiesROC CurveLymph node metastasisNomogramPrediction modelPTCTI-RADS

Identifiers

PMID41998526
PMCPMC13214450

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.