A prognostic nomogram for papillary thyroid cancer lymph node metastasis based on immune score

Area of Science:

• Oncology
• Immunology
• Genomics

Background:

• Papillary thyroid cancer (PTC) is the most common thyroid malignancy.
• Early lymph node metastasis is a key characteristic of PTC.
• The tumor immune microenvironment influences PTC progression and metastasis.

Purpose of the Study:

• To develop a clinical nomogram for predicting lymph node metastasis in PTC patients.
• To explore the prognostic value of immune scores in PTC metastasis.

Main Methods:

• Utilized genomic and clinical data from 447 PTC patients from The Cancer Genome Atlas (TCGA).
• Employed logistic regression for univariate and multivariate analyses to identify predictors.
• Constructed a prognostic nomogram and assessed its accuracy using concordance index (C-index) and calibration curves.

Main Results:

• Patients with high immune scores exhibited significantly higher risks of lymph node metastasis (OR: 1.774, 95% CI: 1.130-2.784).
• The nomogram achieved a C-index of 0.722 (95% CI: 0.671-0.774), indicating favorable predictive performance.
• Calibration curves demonstrated good agreement between predicted and observed lymph node metastasis.

Conclusions:

• Elevated immune scores are strongly associated with increased lymph node metastasis risk in PTC.
• Immune score-based nomograms show potential for clinical application in predicting PTC metastasis.