Application Value of Preoperative NLR and TSH in Predicting the Risk of Lymph Node Metastasis in the Lateral Region of Papillary Thyroid Cancer
Objective To investigate the application value of preoperative neutrophil-to-lymphocyte ratio(NLR)and thyroid stimulating hormone(TSH)in predicting the risk of lymph node metastasis in the lateral cervical region in papillary thyroid cancer(PTC).Methods Clinical data of 654 patients with PTC were analyzed,and cut-off values for NLR,TSH,and other serological indi-ces were obtained by receiver operating characteristic(ROC)curves for continuous variables.Binary Logistic regression analysis was per-formed,and independent risk factors were included in the Logistic regression model to establish a nomogram.The accuracy and discrimi-nation of the prognostic model were evaluated using C-index and calibration curves.Clinical decision analysis(DCA)curve were used to predict the potential for clinical application.Results The results of multivariate Logistic regression analysis showed that preoperative NLR,TSH,Tg/TSH,T stage,and number of tumor foci were the independent risk factors affecting lymph node metastasis in the lateral neck region of PTC patients(P<0.05),and a nomogram was constructed with a C-index of 0.730,and the model was validated with a C-index of 0.719,and its calibration curve had good agreement,and the DCA curve indicated a good clinical potential.Conclusion The preoperative NLR low value group and TSH high value group combined with other clinical factors have significant predictive value in predicting lymph node metastasis in the lateral cervical region of PTC.