{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:31:01Z","timestamp":1790137861931,"version":"4.0.1"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Thyroid carcinoma is one of the most common endocrine tumors, and papillary thyroid carcinoma (PTC) is the most common pathological type. Current studies have reported that PTC has a strong propensity for central lymph node metastases (CLNMs). Whether to prophylactically dissect the central lymph nodes in PTC remains controversial. This study aimed to explore the risk factors and develop a predictive model of CLNM in PTC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 2,554 patients were enrolled in this study. The basic information, laboratory examination, characteristics of cervical ultrasound, genetic test, and pathological diagnosis were collected. The collected data were analyzed by univariate logistic analysis and multivariate logistic analysis. The risk factors were evaluated, and the predictive model was constructed of CLNM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The multivariate logistic analysis showed that Age (p &amp;lt; 0.001), Gender (p &amp;lt; 0.001), Multifocality (p &amp;lt; 0.001), <jats:italic>BRAF<\/jats:italic> (p = 0.027), and Tumor size (p &amp;lt; 0.001) were associated with CLNM. The receiver operating characteristic curve (ROC curve) showed high efficiency with an area under the ROC (AUC) of 0.781 in the training group. The calibration curve and the calibration of the model were evaluated. The decision curve analysis (DCA) for the nomogram showed that the nomogram can provide benefits in this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The predictive model of CLNM constructed and visualized based on the evaluated risk factors was confirmed to be a practical and convenient tool for clinicians to predict the CLNM in PTC.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.856278","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T04:54:45Z","timestamp":1655355285000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["A Clinical Predictive Model of Central Lymph Node Metastases in Papillary Thyroid Carcinoma"],"prefix":"10.3389","volume":"13","author":[{"given":"Zipeng","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qungang","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanyin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gongbo","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanlin","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Detao","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e2118526","DOI":"10.1001\/jamanetworkopen.2021.18526","article-title":"Prevalence of Hashimoto Thyroiditis in Adults With Papillary Thyroid Cancer and Its Association With Cancer Recurrence and Outcomes","volume":"4","author":"Xu","year":"2021","journal-title":"JAMA Netw Open"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej11-0355","article-title":"Prognosis and Prognostic Factors of Patients With Papillary Thyroid Carcinoma Requiring Resection of Recurrent Laryngeal Nerve Due to Carcinoma Extension","volume":"59","author":"Yasuhiro Ito","year":"2012","journal-title":"Endocrine J"},{"key":"B3","unstructured":"Consensus Statement on the Terminology and Classification of Central Neck Dissection for Thyroid Cancer\n            CartySE\n            DohertyGM\n            DuhQ-Y\n            KloosRT\n            MandelSJ\n            RandolphGW\n          10.1089\/thy.2009.0159Thyroid112009"},{"key":"B4","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.soc.2015.08.013","article-title":"Surgical Management of Lymph Node Compartments in Papillary Thyroid Cancer","volume":"25","author":"Sturgeon","year":"2016","journal-title":"Surg Oncol Clin N Am"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-012-1826-3","article-title":"Preoperative Prediction of Central Lymph Node Metastasis in Thyroid Papillary Microcarcinoma Using Clinicopathologic and Sonographic Features","volume":"37","author":"Kim","year":"2013","journal-title":"World J Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2009","DOI":"10.1089\/thy.2009.1578","article-title":"The Pros and Cons of Prophylactic Central Compartment Lymph Node Dissection for Papillary Thyroid Carcinoma","volume":"19","author":"Mazzaferri","year":"2009","journal-title":"Thyroid"},{"key":"B7","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.otc.2010.01.005","article-title":"Surgical Management of Cervical Lymph Nodes in Differentiated Thyroid Cancer","volume":"43","author":"Fritze","year":"2010","journal-title":"Otolaryngol Clin North Am"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.791970","article-title":"Clinical Study of Ultrasonographic Risk Factors for Central Lymph Node Metastasis of Papillary Thyroid Carcinoma","volume":"12","author":"Guang","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.1016\/j.surg.2010.09.019","article-title":"Influence of Prophylactic Central Lymph Node Dissection on Postoperative Thyroglobulin Levels and Radioiodine Treatment in Papillary Thyroid Cancer","volume":"148","author":"Hughes","year":"2010","journal-title":"Surgery"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12506","article-title":"Routine Prophylactic Central Neck Dissection for Low-Risk Papillary Thyroid Cancer Is Not Cost-Effective","volume":"81","author":"Garcia","year":"2014","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0130","article-title":"Multifocal Papillary Thyroid Cancer Increases the Risk of Central Lymph Node Metastasis","volume":"25","author":"Al Afif","year":"2015","journal-title":"Thyroid"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-013-1152-8","article-title":"Prophylactic Central Neck Disection in Papillary Thyroid Cancer: A Consensus Report of the European Society of Endocrine Surgeons (ESES)","volume":"399","author":"Sancho","year":"2014","journal-title":"Langenbecks Arch Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","article-title":"Mice: Multivariate Imputation by Chained Equations in R","volume":"45","author":"Buuren","year":"2011","journal-title":"J Stat Software"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14302","article-title":"A Nomogram Model Based on the Preoperative Clinical Characteristics of Papillary Thyroid Carcinoma With Hashimoto\u2019s Thyroiditis to Predict Central Lymph Node Metastasis","volume":"94","author":"Zhao","year":"2021","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B15","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1089\/thy.2013.0367","article-title":"Patient Age is Significantly Related to the Progression of Papillary Microcarcinoma of the Thyroid Under Observation","volume":"24","author":"Ito","year":"2014","journal-title":"Thyroid"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.20892\/j.issn.2095-3941.2018.0125","article-title":"Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Study of 1,587 Patients","volume":"16","author":"Zheng","year":"2019","journal-title":"Cancer Biol Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-14-0053","article-title":"Estrogen and Its Role in Thyroid Cancer","volume":"21","author":"Derwahl","year":"2014","journal-title":"Endocr Relat Cancer"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0176","article-title":"Preoperative High-Resolution Ultrasound for the Assessment of Malignant Central Compartment Lymph Nodes in Papillary Thyroid Cancer","volume":"25","author":"Khokhar","year":"2015","journal-title":"Thyroid"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4419","article-title":"BRAF(V600E) Mutation Test on Fine-Needle Aspiration Specimens of Thyroid Nodules: Clinical Correlations for 4600 Patients","volume":"11","author":"Chen","year":"2021","journal-title":"Cancer Med"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-2785","article-title":"TERT, BRAF, and NRAS in Primary Thyroid Cancer and Metastatic Disease","volume":"102","author":"Melo","year":"2017","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21055","article-title":"The Prognostic Value of Primary Tumor Size in Papillary and Follicular Thyroid Carcinoma","volume":"103","author":"Machens","year":"2005","journal-title":"Cancer"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-001-0176-3","article-title":"Pattern of Nodal Metastasis for Primary and Reoperative Thyroid Cancer","volume":"26","author":"Machens","year":"2002","journal-title":"World J Surg"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3390\/jcm7080183","article-title":"Calcification Patterns in Papillary Thyroid Carcinoma Are Associated With Changes in Thyroid Hormones and Coronary Artery Calcification","volume":"7","author":"Ha","year":"2018","journal-title":"J Clin Med"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej12-0294","article-title":"Relationship Between Patterns of Calcification in Thyroid Nodules and Histopathologic Findings","volume":"60","author":"Bu Kyung Kim","year":"2012","journal-title":"Endocrine J"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-021-01524-5","article-title":"Construction and Validation of a Nomogram for Predicting Cervical Lymph Node Metastasis in Classic Papillary Thyroid Carcinoma","volume":"44","author":"Feng","year":"2021","journal-title":"J Endocrinol Invest"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-06906-6","article-title":"Papillary Thyroid Carcinoma: An Ultrasound-Based Nomogram Improves the Prediction of Lymph Node Metastases in the Central Compartment","volume":"30","author":"Tian","year":"2020","journal-title":"Eur Radiol"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.856278\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T04:54:47Z","timestamp":1655355287000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.856278\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,16]]},"references-count":26,"alternative-id":["10.3389\/fendo.2022.856278"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.856278","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,16]]},"article-number":"856278"}}