Establishment and Validation of A Nomogram Predictive Model for Benign and Malignant Thyroid Nodules Based on Ultra-sound Indicators

AYI Erhong; CHEN Zhiyuan; HAN Liming; ZHOU Wenxiu; WEI Xing; ZHANG Xusheng

doi:10.13730/j.issn.2097-2148.2024.08.007

Abstract：Objective To establish a Nomogram predictive model for benign and malignant thyroid nodules based on ultrasound indicators and validate it.Methods The clinical data of 423 patients who underwent thyroid nodule surgery in author's hospital from April 2021 to July 2023,with complete medical records and clear postoperative pathological diagno-sis were selected.The patients were divided into model group(n=296)and validation group(n=127)according to ad-mission time.General information,routine ultrasound,real-time elastography and contrast-enhanced ultrasound indica-tors of those patients were collected.The model group patients were divided into benign group(n=93)and malignant group(n=203)according to the pathological examination results,the general information,routine ultrasound,real-time elastography and contrast-enhanced ultrasound indicators of the two groups of patients were compared,potential variables were screened using least absolute shrinkage and selection operator(LASSO)regression and multivariate Logistic regres-sion were performed,and a Nomogram predictive model was established and validated.Results Among the 296 patients in the model group,203 were diagnosed with malignant tumors through pathological examination.The results of multiva-riate Logistic regression analysis showed that age,number of nodules,aspect ratio,boundary,elasticity mean(Emean),uniformity,peak intensity(PI)and area under the curve(AUC)were independent influencing factors for benign and ma-lignant thyroid nodules(all P＜0.05).Column chart model was established using R software based on the results of multi factor regression analysis.The receiver operating characteristic(ROC)curve analysis results showed that the AUC of the model group's nomogram for predicting benign and malignant thyroid nodules was 0.836,95％confidence interval(CI)was 0.787-0.886 specificity was 68.80％and sensitivity was 81.80％;the AUC of the validation group's column chart for predicting benign and malignant thyroid nodules was 0.808,95％CI was 0.752-0.863,specificity was 72.00％and sensitivity was 82.10％.The calibration curve analysis results showed that the pre-dicted curves of the model group and validation group are basically fitted with the standard curve.The decision curve re-sults show that when the predicted value of the model was 18.20％-88.50％,the patient's net benefit rate was greater than 0.Conclusion The benign or malignancy of thyroid nodules is related to age,number of nodules,aspect ratio and other factors.The Nomogram prediction model based on ultrasound indicators can be used to predict the benign or malig-nancy of thyroid nodules.