The DCA for each indicator demonstrated that when the probability of nodal diameter threshold was 14%−48% for nodal diameter alone; 24%−48% for gender alone; 22%−39% for ALB alone; 10%−31% for APOB alone; 24%−62% for TG alone and at 3%−77% threshold probability for the five indicators combination, the net clinical benefit rate for each indicator was greater than that of the regimen in which all PTMC patients had lymph node metastases or none of them had metastases. This evidence concerns the gene ALB and metastatic malignant neoplasm in the lymph nodes.