Development of a nomogram incorporating BRAF-V600E to predict central lymph node metastasis in papillary thyroid...

ObjectiveThis study aims to identify risk factors associated with central lymph node metastasis (CLNM) in individuals with papillary thyroid carcinoma (PTC) and to develop a predictive nomogram model, thereby offering clinicians a valuable tool for guiding surgical treatment decisions in PTC management.MethodsClinical and ultrasound data were collected from 348 patients with PTC who underwent surgical treatment at our hospital between July 2022 and November 2023. The cohort was randomly divided into a training group (n = 243) and a validation group (n = 105 cases). Independent risk factors for CLNM were identified using multivariate logistic regression analysis, which was subsequently used to construct a predictive nomogram. The performance of the model was internally validated, and its predictive accuracy was evaluated using receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves.ResultsAmong the 348 patients, CLNM was observed in 115 (47.33%) patients in the training group and 48 (45.71%) patients in the validation group. Univariate and multivariate logistic regression analyses revealed that male sex, age under 55 years, nodular anteroposterior diameter of ≥1 cm, BRAF-V600E gene mutation, and tumor capsule invasion were independent risk factors for CLNM in PTC (P < 0.05). The constructed nomogram demonstrated strong predictive capability, with areas under the ROC curve (AUC) of 0.84 (95% CI, 0.78-0.89) for the training group and 0.85 (95% CI, 0.78-0.93) for the validation group.ConclusionThe nomogram constructed based on ultrasound and BRAF-V600E gene mutation status is a reliable predictive tool for CLNM in patients with PTC, potentially aiding clinicians in the formulation of personalized surgical treatment strategies.