Relationship between blood inflammatory indicators and cervical lymph node metastasis in cN0 stage papillary thyroid carcinoma
Objective To analyze the relationship between preoperative blood inflammatory indicators and cervical lymph node metastasis in patients with cN0 stage papillary thyroid carcinoma(PTC),and to explore the predictive value of clinical characteristics and blood inflammatory indicators for cervical lymph node metastasis in patients with cN0 stage PTC.Method A total of 418 cN0 stage PTC patients diagnosed by preoperative imaging examination were divided into lymph node without metastasis group and lymph node metastasis group according to postoperative pathology.The clinical characteristics and blood inflammatory indicators of the two groups were compared.The risk factors of cervical lymph node metastasis in cN0 stage PTC patients were analyzed by Logistic regression model and a prediction model was estab-lished.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of preoperative blood inflammatory indicators for cervical lymph node metastasis in cN0 stage PTC patients,and the relationship between blood inflammatory indicators and tumor pathological characteristics of cN0 stage PTC patients was analyzed.Result The gen-der,age,tumor diameter,white blood cell count,neutrophil count,monocyte count,neutrophil to lymphocyte ratio(NLR),systemic immune inflammation index(SⅡ)and systemic inflammatory response index(SIRI)were compared be-tween the lymph node without metastasis group and lymph node metastasis group,the differences were statistically signif-icant(P＜0.05).Multivariate analysis showed that age,tumor diameter and SⅡ were independent influencing factors for cervical lymph node metastasis in cN0 stage PTC patients(P＜0.05).The area under the curve(AUC)of the prediction model established based on the above influencing factors for predicting cervical lymph node metastasis in cN0 stage PTC patients was 0.743,95％CI:0.686-0.799,P＜0.01.When the cut-off value was 0.197,the sensitivity was 0.755,and the specificity was 0.648.The AUC of NLR,SIRI and SⅡ in predicting cervical lymph node metastasis in cN0 stage PTC patients were 0.644,0.660 and 0.670,respectively,the cut-off values were 1.605,0.815 and 419.405,respectively,and the corresponding sensitivities were 63.8％,51.1％and 59.6％,respectively,the specificities were 57.7％,75.6％and 68.2％,respectively.Tumor diameter was compared between the low NLR group and the high NLR group,the difference was sta-tistically significant(P＜0.05);tumor diameter,T stage and extra thyroidal extension were compared between the low SIRI group and the high SIRI group,the differences were statistically significant(P＜0.05).Conclusion Preoperative blood inflammatory indicators are associated with cervical lymph node metastasis in cN0 stage PTC patients.The predic-tion model based on age,tumor diameter and SⅡ can provide a reference for evaluating cervical lymph node metastasis in PTC patients with negative imaging findings.
papillary thyroid carcinomasystemic immune inflammation indexcervical lymph node metastasispre-diction model
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