Construction and validation of a nomogram based on inflammatory, nutritional and metabolic indicators for predicting the risk of papillary thyroid carcinoma

Objective To analyze the correlation between inflammation, nutrition and metabolic indicators and the risk of papillary thyroid carcinoma (PTC), and to construct and validate a nomogram for predicting PTC risk among patients with thyroid nodules undergoing surgery, to assist clinicians in making more individualized clinical decisions. Study design Retrospective population-based cohort study. Methods A retrospective study was conducted on the clinical medical records of patients with thyroid masses who underwent surgical treatment at Hebei General Hospital from 2020 to 2024. Independent risk factors for the onset of PTC were screened through Logistic regression analysis. A risk prediction model for the onset of PTC based on inflammatory, nutritional and metabolic indicators was constructed using R4.3.3 software and externally validated. Results A total of 1727 patients who underwent thyroidectomy for thyroid nodules were enrolled, among whom 1167 patients (67.6%) were pathologically-confirmed papillary thyroid carcinoma (PTC), and 560 patients (32.4%) had benign thyroid nodules after surgery. Multivariate logistic regression analysis demonstrated combined Hashimoto’s thyroiditis (HT) (OR = 1.887, 95%CI: 1.174-3.031, P = 0.009), combined metabolic syndrome (MetS) (OR = 2.157, 95%CI: 1.449-3.211, P < 0.001), and elevated uric acid (UA) (OR = 1.640, 95%CI: 1.112-2.417, P = 0.013) were independent risk factors for PTC onset. Age ≥ 55 years (OR = 0.318, 95%CI: 0.238-0.424, P < 0.001), other marital status (OR = 0.067, 95%CI: 0.012-0.392, P = 0.003), and increased prognostic nutritional index (PNI) (OR = 0.934, 95%CI: 0.902-0.966, P < 0.001) were independent protective factors against PTC onset. Based on the above independent risk factors, a nomogram for PTC was constructed. The AUC of the ROC curve in the modeling group was 0.702, and that in the external validation group was 0.721, indicating that the nomogram has good predictive performance. The calibration curve and decision analysis curve also indicate that the nomogram has good predictive performance and clinical application efficacy. Conclusion Combined HT, combined MetS, and elevated UA are independent risk factors for PTC onset, whereas age ≥ 55 years, other marital status, and PNI level represent independent protective factors.