Objective Our goal was to investigate the correlation between papillary thyroid carcinoma (PTC) characteristics on ultrasonography and metastases of lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN). There is still no good method for clinicians to judge whether a patient needs LN-prRLN resection before surgery, and we also wanted to establish a new scoring system to determine whether patients with papillary thyroid carcinoma require LN-prRLN resection before surgery. Patients and Methods There were 482 patients with right or bilateral PTC who underwent thyroid gland resection from December 2015 to December 2017 recruited as study subjects. The relationship between the PTC characteristics on ultrasonography and the metastases of LN-prRLN was analyzed by univariate and logistic regression analyses. Based on the risk factors identified in univariate and logistic regression analysis, a nomogram-based LN-prRLN prediction model was established. Result LN-prRLN were removed from all patients, of which 79 had LN-prRLN metastasis, with a metastasis rate of 16.39%. Multivariate logistic regression analysis revealed that LN-prRLN metastasis was closely related to sex, age, blood supply, larger tumors (> 1 cm) and capsular invasion. A risk prediction model has been established and fully verified. The calibration curve used to evaluate the nomogram shows that the consistency index was 0.75 ± 0.065. Conclusion Preoperative clinical data, such as sex, age, abundant blood supply, larger tumor (> 1 cm) and capsular invasion, are positively correlated with LN-prRLN metastasis. Our scoring system can help surgeons non-invasively determine which patients should undergo LN-prRLN resection before surgery. We recommend that LN-prRLN resection should be performed when the score is above 103.1.

中文翻译：

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一种新的评分系统，通过术前超声预测甲状腺乳头状癌患者右后复发喉神经淋巴结受累的转移。

目的探讨甲状腺乳头状癌（PTC）超声检查特征与右喉返神经后淋巴结转移（LN-prRLN）的相关性。目前还没有很好的方法让临床医生判断患者术前是否需要行LN-prRLN切除，我们也想建立一个新的评分系统来判断甲状腺乳头状癌患者术前是否需要行LN-prRLN切除。患者与方法 2015 年 12 月至 2017 年 12 月，共纳入 482 例接受甲状腺切除术的右侧或双侧 PTC 患者作为研究对象。通过单变量和逻辑回归分析分析超声检查中的PTC特征与LN-prRLN转移之间的关系。基于单变量和逻辑回归分析中确定的风险因素，建立了基于列线图的LN-prRLN预测模型。结果所有患者均切除LN-prRLN，其中79例发生LN-prRLN转移，转移率为16.39%。多因素logistic回归分析显示LN-prRLN转移与性别、年龄、血供、较大肿瘤（> 1 cm）和包膜侵犯密切相关。建立并充分验证了风险预测模型。用于评估列线图的校准曲线显示一致性指数为 0.75 ± 0.065。结论 性别、年龄、血供丰富、肿瘤较大（> 1 cm）、是否侵犯包膜等术前临床资料与LN-prRLN转移呈正相关。我们的评分系统可以帮助外科医生无创地确定哪些患者应该在手术前接受 LN-prRLN 切除术。我们建议在评分高于 103.1 时进行 LN-prRLN 切除。