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 of the patients between with and without LLNM in the training set. Then the risk factors 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 the 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, 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%CI) of the nomogram prediction model constructed based on these 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 cancer lesion diameter, cancer lesion 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 developed based on these risk factors demonstrates good discrimination, accuracy, and clinical applicability for its prediction.
目的 觀察鹽酸氨基葡萄糖對兔關節腔積血造成的軟骨損傷的保護作用。 方法 成年新西蘭大白兔50只，隨機分為A、B、C、D、E共5組，每組10只。A、B、C、D組采用自體靜脈血4 mL右側關節腔內注射建立關節腔積血模型。建模后，A、B、C組分別給予25、82.5、500 mg/kg的鹽酸氨基葡萄糖灌胃，1次/d；D組為陽性對照組，以6 mL/kg蒸餾水灌胃，1次/d；E組為陰性對照組，以6 mL/kg蒸餾水灌胃，1次/d。灌胃8周后取材。肉眼大體觀察，光鏡下進行Mankin評分及沙紅O染色觀察，評估軟骨損傷程度；采用免疫組織化學法測定Ⅱ型膠原蛋白（COL Ⅱ）表達情況。 結果 軟骨大體觀察和沙紅O染色組織學觀察顯示，A、B、C組與D組、E組之間差異均有統計學意義（P＜0.05）。免疫組織化學提示，A、B、C組COL Ⅱ表達明顯高于D組（P＜0.05）。 結論 鹽酸氨基葡萄糖對兔關節腔積血導致的軟骨損傷有一定的保護治療作用，在防治關節腔積血導致的軟骨損傷的發生發展方面，具有一定的作用。