[Establishment and validation of a nomogram model for evaluating the metastasis of lymph nodes posterior to the right recurrent laryngeal nerve in papillary thyroid carcinoma].

Objective: To explore the related factors of lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in papillary thyroid carcinoma (PTC) and establish a nomogram model for evaluating LN-prRLN metastasis. Methods: The clinical data of patients with PTC who underwent surgery in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2021 were retrospectively analyzed. Multivariate logistic regression was used to analyze the related factors of LN-prRLN metastasis and construct a nomogram model for evaluating LN-prRLN metastasis. Meanwhile, the data of 120 patients from January to June 2022 were also collected for external verification. Results: A total of 466 patients with PTC were enrolled, including 106 males and 360 females, and aged 44 (33, 53) years. There were 280 cases in the training group and 186 cases in the internal validation group, respectively. Multivariate logistic regression analysis showed that age (OR=0.966, 95%CI: 0.938-0.996, P=0.027), tumor size (OR=1.048, 95%CI: 1.001-1.098, P=0.043), multifocality (OR=2.459, 95%CI: 1.268-4.767, P=0.008), right central lymph node metastasis reported by ultrasound (OR=3.099, 95%CI: 1.255-7.651, P=0.014), extrathyroid extension (OR=3.561, 95%CI: 1.255-10.102, P=0.017) and serum thyroglobulin level (OR=1.010, 95%CI: 1.001-1.018, P=0.032) were related factors for LN-prRLN metastasis. The area under the curve (AUC) values of receiver operating characteristic (ROC) curves of the training group, internal validation group and external validation group were 0.765 (95%CI: 0.691-0.840), 0.747 (95%CI: 0.657-0.837) and 0.754 (95%CI: 0.639-0.869), respectively. Conclusion: Dissection of the LN-prRLN is recommended for young PTC patients with large tumor size, multifocality, right central lymph node metastasis reported by ultrasound, extrathyroid extension and high serum thyroglobulin level.

[Clinical pathology and incidence trend of thyroid cancer based on 21 980 cases].

Objective: To analyze the clinical pathological characteristics and incidence of thyroid cancer. Methods: The clinical and pathological data of 21 980 thyroid cancer patients who underwent surgery in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2018, including the gender, age, pathological type, tumor size, tumor number, central and lateral lymph node metastasis, was retrospectively analyzed. Results: There were 16 895 females and 5 085 males (gender ratio: 3.3 to 1), aged 4 to 95 (47.6±11.8) years old. Except for 2012, the average onset age of females was higher than that of males, and both genders showed a trend of early onset over time (females: Z=-2.703, P=0.007; males: Z=-3.004, P=0.003). The proportion of female aged 25 to 39 and male aged 20 to 39 was increasing, but the proportion of both genders aged over 60 was decreasing (all P<0.05). With the increase of tumor length and diameter, the positive rate of central lymph nodes metastasis (Z=-2.205, P=0.027) and lateral lymph node metastasis (Z=-2.205, P=0.027) gradually increased. Conclusions: The onset age of thyroid cancer exhibited a much younger trend, with an increasing proportion of women aged 25-39 and men aged 20-39. Therefore, it should be suggested to strengthen the screening of people in the corresponding age range. The newly diagnosed thyroid cancer was mainly thyroid micropapillary carcinoma, with a high proportion of lymph node metastasis and multiple foci, and thus the optimal treatment methods need to be carefully considered.