ObjectiveTo establish a prediction model for ipsilateral cervical lateral lymph node metastasis (LLNM) in stages T1–T2 unilateral papillary thyroid carcinoma (PTC) and to verify its efficacy. MethodsA retrospective case-control study was conducted to analyze the clinical information of 280 patients with unilateral PTC at stages T1–T2 who underwent ipsilateral cervical lateral lymph node dissection and were diagnosed postoperatively via pathological examination in the Department of Thyroid Surgery (General Surgery) at the First Hospital of Shanxi Medical University from February 2019 to February 2024. The patients were randomly allocated into a training set and a test set in a 7∶3 ratio. The general, clinical, laboratory, and imaging data were collected for all patients. The univariate and multivariate logistic regression analyses were used to compare the differences in data between the patients with and without LLNM in the training set. Then the risk factor affecting on the LLNM were used to construct a nomogram prediction model. The receiver operating characteristic (ROC) curve was generated for both the training and test sets, and the area under the ROC curve (AUC) was calculated to evaluate model discrimination. The calibration curve was used to assess model calibration, and decision curve analysis (DCA) was conducted to evaluate the clinical utility of the nomogram prediction model. ResultsA total of 280 patients were included, including 196 in the training set and 84 in the testing set. There were no statistically significant differences in clinical and pathological data between the training set and the testing set (P>0.05). There were 147 cases of LLNM in the training set and 63 cases of LLNM in the testing set. The results of multivariate logistic regression analysis showed that the patients with T1–T2 stage unilateral PTC who were male in gender, had cancer lesions located in the upper pole, had central lymph node metastasis, and had larger cancer lesions and higher serum thyroid stimulating hormone level had a higher probability of developing ipsilateral cervical LLNM (P<0.05). The AUC (95% confidence interval) of the nomogram prediction model constructed based on these independent risk factors in the training and testing sets were 0.822 (0.747, 0.897) and 0.838 (0.743, 0.933), respectively. The calibration curves of the training and testing sets roughly overlapped with the reference curve. The DCA results indicated that the net benefit for patients was positive when the threshold probabilities were within the ranges of 15% to 92% for the training set and 10% to 100% for the test set. ConclusionsThe results of this study suggest that gender, maximum tumor diameter, tumor location, central lymph node metastasis, and serum thyroid stimulating hormone are risk factors affecting the occurrence of ipsilateral cervical LLNM in T1–T2 stages unilateral PTC. The nomogram prediction model constructed based on this demonstrates good discrimination, accuracy, and clinical applicability for its prediction.
目的 观察盐酸氨基葡萄糖对兔关节腔积血造成的软骨损伤的保护作用。 方法 成年新西兰大白兔50只，随机分为A、B、C、D、E共5组，每组10只。A、B、C、D组采用自体静脉血4 mL右侧关节腔内注射建立关节腔积血模型。建模后，A、B、C组分别给予25、82.5、500 mg/kg的盐酸氨基葡萄糖灌胃，1次/d；D组为阳性对照组，以6 mL/kg蒸馏水灌胃，1次/d；E组为阴性对照组，以6 mL/kg蒸馏水灌胃，1次/d。灌胃8周后取材。肉眼大体观察，光镜下进行Mankin评分及沙红O染色观察，评估软骨损伤程度；采用免疫组织化学法测定Ⅱ型胶原蛋白（COL Ⅱ）表达情况。 结果 软骨大体观察和沙红O染色组织学观察显示，A、B、C组与D组、E组之间差异均有统计学意义（P＜0.05）。免疫组织化学提示，A、B、C组COL Ⅱ表达明显高于D组（P＜0.05）。 结论 盐酸氨基葡萄糖对兔关节腔积血导致的软骨损伤有一定的保护治疗作用，在防治关节腔积血导致的软骨损伤的发生发展方面，具有一定的作用。