Abstract： OBJECTIVE To analyze the influencing factors of postoperative anxiety in patients with thyroid cancer(TC),and to establish a risk prediction nomogram model.METHODS From January 2019 to June 2023,457 TC patients who underwent surgical treatment at our hospital were randomly separated into a modeling group(320 cases)and a validation group(137 cases)using a random number table method,with a ratio of approximately 7∶3.TC patients were grouped into anxiety group and non anxiety group based on whether they experience anxiety after surgery.Clinical follow-up data of patients were collected,multivariate Logistic regression was applied to analyze the influencing factors of postoperative anxiety in TC patients,R software and RMS package were applied to establish a nomogram model of postoperative anxiety in TC patients.The calibration curve and Hosmer-Leme show(H-L)test were applied to evaluate the fitting degree of the nomogram model.ROC curve was applied to evaluate and validate the effectiveness of predictive models.RESULTS Multivariate Logistic regression analysis showed that family monthly income≤4 000 yuan,marital status as no spouse,on-the-job work,no health education,moderate to high risk of disease recurrence,and surgical method as total thyroidectomy were risk factors for postoperative anxiety in TC patients(P<0.05).In the modeling group,the AUC predicted by the nomogram for postoperative anxiety in TC patients was 0.842(95%CI:0.797-0.880),and the calibration curve was close to the ideal curve,the H-L test was χ2=8.323,P=0.403,and the calibration was good,the risk of postoperative anxiety in TC patients predicted by the nomogram model was basically consistent with the actual risk.In the validation group,the AUC in predicting postoperative anxiety in TC patients was 0.865(95%CI:0.796-0.917);the calibration curve was relatively close to the ideal curve,H-L test showed χ2=5.618 and P=0.585,the nomogram model has good consistency with predicting postoperative anxiety risk in TC patients with actual results.CONCLUSION Family monthly income≤4 000 yuan,no spouse,on-the-job work,no health education,moderate to high risk of disease recurrence,and total thyroidectomy are risk factors for postoperative anxiety in TC patients.The nomogramt model established based on this has good predictive differentiation and can provide reference for early screening and prevention of postoperative anxiety in TC patients.