Objective: To comprehensively investigate the predictive value of thyroid hormone sensitivity parameters for cervical lymph node metastasis in patients diagnosed with differentiated thyroid cancer (DTC) undergoing total thyroidectomy and neck lymph node dissection.
Methods: A retrospective cohort study was conducted involving patients diagnosed with DTC and evaluated for cervical lymph node metastasis. Relevant demographic, tumour, lymph node and thyroid hormone sensitivity parameter data were extracted from medical records and laboratory reports. Thyroid hormone sensitivity parameters including thyroxine (T4), triiodothyronine (T3), thyroid-stimulating hormone (TSH), thyroglobulin (Tg), thyroglobulin antibodies (TgAbs), thyroid peroxidase antibody, thyroid hormone receptor α and TSH receptor antibody were assessed. Statistical analyses including descriptive statistics, comparative analysis, Pearson's correlation analysis, logistic regression analysis, receiver operating characteristic (ROC) analysis and construction of a multivariable prediction model based on machine learning using the xgbTree method were employed to evaluate the associations and predictive value of thyroid hormone sensitivity parameters for cervical lymph node metastasis.
Results: The study revealed significant associations between several thyroid hormone sensitivity parameters and cervical lymph node metastasis in patients with DTC. Specifically, higher levels of T4, T3, Tg, TgAbs and TSH receptor antibody were associated with lymph node metastasis. Pearson's correlation analysis, logistic regression analysis and ROC analysis further underscored the predictive performance of these parameters, with strong overall discriminative abilities. The machine learning-based prediction model demonstrated promising performance with a high area under the curve (AUC) of 0.979.
Conclusions: The findings provide compelling evidence for the predictive value of thyroid hormone sensitivity parameters, particularly T3, T4, Tg, TgAbs and TSH receptor antibody, in identifying and evaluating the likelihood of cervical lymph node metastasis in patients with DTC. These parameters hold potential implications for risk stratification, clinical decision-making and personalized management strategies, contributing to improved outcomes for patients at risk of lymph node metastasis.
Keywords: Thyroid cancer; differentiated thyroid cancer; lymph node metastasis; predictive value; risk stratification; thyroid hormone sensitivity parameters.