{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:34:38Z","timestamp":1787747678087,"version":"build-2784847793"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T00:00:00Z","timestamp":1656979200000},"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>Introduction<\/jats:title><jats:p>Skip metastasis, referred to as lymph node metastases to the lateral neck compartment without involvement of the central compartment, is generally unpredictable in papillary thyroid carcinoma (PTC). This study aims to establish an effective predictive model for skip metastasis in PTC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Meterials and Methods<\/jats:title><jats:p>Retrospective analysis was performed of clinical samples from 18192 patients diagnosed with thyroid cancer between 2016 to 2020. The First Affiliated Hospital of Wenzhou Medical University. The lateral lymph node metastasis was occureed in the training set (630 PTC patients) and validation set (189 PTC patients). The univariate and multivariate analyses were performed to detect the predictors of skip metastasis and the support vector machine (SVM) was used to establish a model to predict skip metastasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rate of skip metastasis was 13.3% (84\/631). Tumor size (\u226410 mm), upper location, Hashimoto\u2019s thyroiditis, extrathyroidal extension, absence of BRAFV600E mutation, and less number of central lymph node dissection were considered as independent predictors of skip metastasis in PTC. For the training set, these predictors performed with 91.7% accuracy, 86.4% sensitivity, 92.2% specificity, 45.2% positive predictive value (PPV), and 98.9% negative predictive value (NPV) in the model. Meanwhile, these predictors showed 91.5% accuracy,71.4% sensitivity, 93.1% specificity, 45.5% PPV, and 97.6% NPV in validation set.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study screened the predictors of the skip lateral lymph node metastasis and to establish an effective and economic predictive model for skip metastasis in PTC. The model can accurately distinguish the skip metastasis in PTC using a simple and affordable method, which may have potential for daily clinical application in the future.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.916121","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T12:42:10Z","timestamp":1657024930000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["A Novel and Effective Model to Predict Skip Metastasis in Papillary Thyroid Carcinoma Based on a Support Vector Machine"],"prefix":"10.3389","volume":"13","author":[{"given":"Shuting","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingxuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danni","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiying","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binbin","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guowan","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yefeng","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global Cancer Statistics 2018: Globocan Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.ecl.2018.10.002","article-title":"Evolving Understanding of the Epidemiology of Thyroid Cancer","volume":"48","author":"Seib","year":"2019","journal-title":"Endocrinol Metab Clin North Am"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/965212","article-title":"Worldwide Increasing Incidence of Thyroid Cancer: Update on Epidemiology and Risk Factors","volume":"2013","author":"Pellegriti","year":"2013","journal-title":"J Cancer Epidemiol"},{"key":"B4","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":"B5","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.139.1.43","article-title":"Skip Metastases in Thyroid Cancer Leaping the Central Lymph Node Compartment","volume":"139","author":"Machens","year":"2004","journal-title":"Arch Surg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10144","article-title":"Risk Factors for Recurrence in Patients With Papillary Thyroid Carcinoma Undergoing Modified Radical Neck Dissection","volume":"103","author":"Lee","year":"2016","journal-title":"Br J Surg"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197011)26:5<1053::aid-cncr2820260513>3.0.co;2-x","article-title":"Papillary Carcinoma of the Thyroid. 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