Machine learning-based dynamic prediction of lateral lymph node metastasis in patients with papillary thyroid cancer

Frontiers in Endocrinology - Tập 13
Sheng-wei Lai1, Yunlong Fan1, Yuhua Zhu2, Fei Zhang1, Zheng Guo1, Bing Wang3, Zheng Wan3, Peilin Liu4, Ning Yu2, Han-dai Qin1
1Medical School of Chinese PLA, Beijing, China
2Department of Otolaryngology Head and Neck Surgery, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
3Department of General Surgery, The First Medical Centre of Chinese PLA General Hospital, Beijing, China
4The Third Team, Academy of Basic Medicine, The Fourth Military Medical University, Xi'an, China

Tóm tắt

ObjectiveTo develop a web-based machine learning server to predict lateral lymph node metastasis (LLNM) in papillary thyroid cancer (PTC) patients.MethodsClinical data for PTC patients who underwent primary thyroidectomy at our hospital between January 2015 and December 2020, with pathologically confirmed presence or absence of any LLNM finding, were retrospectively reviewed. We built all models from a training set (80%) and assessed them in a test set (20%), using algorithms including decision tree, XGBoost, random forest, support vector machine, neural network, and K-nearest neighbor algorithm. Their performance was measured against a previously established nomogram using area under the receiver operating characteristic curve (AUC), decision curve analysis (DCA), precision, recall, accuracy, F1 score, specificity, and sensitivity. Interpretable machine learning was used for identifying potential relationships between variables and LLNM, and a web-based tool was created for use by clinicians.ResultsA total of 1135 (62.53%) out of 1815 PTC patients enrolled in this study experienced LLNM episodes. In predicting LLNM, the best algorithm was random forest. In determining feature importance, the AUC reached 0.80, with an accuracy of 0.74, sensitivity of 0.89, and F1 score of 0.81. In addition, DCA showed that random forest held a higher clinical net benefit. Random forest identified tumor size, lymph node microcalcification, age, lymph node size, and tumor location as the most influentials in predicting LLNM. And the website tool is freely accessible at http://43.138.62.202/.ConclusionThe results showed that machine learning can be used to enable accurate prediction for LLNM in PTC patients, and that the web tool allowed for LLNM risk assessment at the individual level.

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Tài liệu tham khảo

Kim, 2020, Geographic influences in the global rise of thyroid cancer, Nat Rev Endocrinol, 16, 17, 10.1038/s41574-019-0263-x

Wu, 2020, Machine learning algorithms for the prediction of central lymph node metastasis in patients with papillary thyroid cancer, Front Endocrinol (Lausanne), 11, 10.3389/fendo.2020.577537

Jiang, 2022, Comparison of supraclavicular oblique incision with traditional low collar incision approach for thyroidectomy in differentiated thyroid cancer, Front Oncol, 12, 10.3389/fonc.2022.842981

Ji, 2022, Efficacy and safety of targeted therapeutics for patients with radioiodine-refractory differentiated thyroid cancer: Systematic review and network meta-analysis, Front Pharmacol, 13, 10.3389/fphar.2022.933648

Wang, 2021, Risk factors and a prediction model of lateral lymph node metastasis in CN0 papillary thyroid carcinoma patients with 1-2 central lymph node metastases, Front Endocrinol (Lausanne), 12, 10.3389/fendo.2021.716728

Gao, 2021, Large-Volume lateral lymph node metastasis predicts worse prognosis in papillary thyroid carcinoma patients with N1b, Front Endocrinol (Lausanne), 12, 10.3389/fendo.2021.815207

Yang, 2022, Diagnostic accuracy of ultrasound, CT and their combination in detecting cervical lymph node metastasis in patients with papillary thyroid cancer: A systematic review and meta-analysis, BMJ Open, 12, e051568, 10.1136/bmjopen-2021-051568

Sudoko, 2021, Thyroid lobectomy for T1 papillary thyroid carcinoma in pediatric patients, JAMA Otolaryngol Head Neck Surg, 147, 10.1001/jamaoto.2021.2359

Haugen, 2016, 2015 American Thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer, Thyroid, 26, 1, 10.1089/thy.2015.0020

Park, 2021, Machine learning-based prediction model using clinico-pathologic factors for papillary thyroid carcinoma recurrence, Sci Rep, 11, 4948, 10.1038/s41598-021-84504-2

Sorrenti, 2022, Artificial intelligence for thyroid nodule characterization: Where are we standing, Cancers (Basel), 14, 10.3390/cancers14143357

Liu, 2019, Risk factor analysis for predicting cervical lymph node metastasis in papillary thyroid carcinoma: A study of 966 patients, BMC Cancer, 19, 622, 10.1186/s12885-019-5835-6

Zhou, 2020, Isthmic papillary thyroid carcinoma presents a unique pattern of central lymph node metastasis, Cancer Manag Res, 12, 10.2147/CMAR.S252692

Machado, 2017, Ultrasonographic evaluation of cervical lymph nodes in thyroid cancer, Otolaryngol Head Neck Surg, 156, 10.1177/0194599816676472

Zhuo, 2022, Dynamic nomogram for predicting lateral cervical lymph node metastasis in papillary thyroid carcinoma, Otolaryngol Head Neck Surg, 166, 10.1177/01945998211009858

Xia, 2022, Construction of a tumor immune microenvironment-related prognostic model in BRAF-mutated papillary thyroid cancer, Front Endocrinol (Lausanne), 13, 10.3389/fendo.2022.895428

Song, 2021, Lateral neck multilevel fine-needle aspiration cytology and thyroglobulin estimation in papillary thyroid carcinoma, Laryngoscope Investig Otolaryngol, 6, 10.1002/lio2.570

Wang, 2019, Nomogram for predicting level V lymph node metastases in papillary thyroid carcinoma with clinically lateral lymph node metastases: A large retrospective cohort study of 1037 patients from FDUSCC, J Cancer, 10, 10.7150/jca.28527

Heng, 2021, Features of lymph node metastasis and structural recurrence in papillary thyroid carcinoma located in the upper portion of the thyroid: A retrospective cohort study, Front Endocrinol (Lausanne), 12, 10.3389/fendo.2021.793997

Chung, 2009, Lateral lymph node metastasis in papillary thyroid carcinoma: results of therapeutic lymph node dissection, Thyroid, 19, 10.1089/thy.2008.0244

Xing, 2020, Thyroid cancer neck lymph nodes metastasis: Meta-analysis of US and CT diagnosis, Eur J Radiol, 129, 10.1016/j.ejrad.2020.109103

Jun, 2015, Overcoming the limitations of fine needle aspiration biopsy: Detection of lateral neck node metastasis in papillary thyroid carcinoma, Yonsei Med J, 56, 10.3349/ymj.2015.56.1.182

Zhan, 2019, Clinicopathological predictors of occult lateral neck lymph node metastasis in papillary thyroid cancer: A meta-analysis, Head Neck, 41, 10.1002/hed.25762

Jin, 2018, Establishing a prediction model for lateral neck lymph node metastasis in patients with papillary thyroid carcinoma, Sci Rep, 8, 17355, 10.1038/s41598-018-35551-9

Mahmoudian, 2021, Stable iterative variable selection, Bioinformatics, 37, 10.1093/bioinformatics/btab501

Wang, 2020, Machine learning-based multiparametric MRI radiomics for predicting the aggressiveness of papillary thyroid carcinoma, Eur J Radiol, 122, 10.1016/j.ejrad.2019.108755

Behr, 2022, Provable boolean interaction recovery from tree ensemble obtained via random forests, Proc Natl Acad Sci U S A, 119, e2118636119, 10.1073/pnas.2118636119

So, 2018, Lateral lymph node metastasis in papillary thyroid carcinoma: A systematic review and meta-analysis for prevalence, risk factors, and location, Int J Surg, 50, 94, 10.1016/j.ijsu.2017.12.029

Feng, 2020, Predictive factors for lateral lymph node metastasis and skip metastasis in papillary thyroid carcinoma, Endocr Pathol, 31, 67, 10.1007/s12022-019-09599-w

Wu, 2019, Predicting factors of lateral neck lymph node metastases in patients with papillary thyroid microcarcinoma, Med (Baltimore), 98, e16386, 10.1097/MD.0000000000016386

Kim, 2017, Risk factors for lateral neck recurrence of N0/N1a papillary thyroid cancer, Ann Surg Oncol, 24, 10.1245/s10434-017-6057-2

Lu, 2020, Clinicopathologic characteristics and outcomes of papillary thyroid carcinoma in younger patients, Med (Baltimore), 99, e19795, 10.1097/MD.0000000000019795

Ryu, 2022, Predictive factors for skip lymph node metastasis and their implication on recurrence in papillary thyroid carcinoma, Biomedicines, 10, 10.3390/biomedicines10010179

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Frontiers in Endocrinology

Tập 13

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