Abstract
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Objectives: In various pathological conditions, most notably in various cancers, strikingly enhanced midkine (MK) over-expression has been noted. We have presented the role of MK in thyroid cancer. This study aimed to investigate the value of dynamic changes of MK to monitor post-surgical patients with papillary thyroid cancer (PTC) who were managed with 131I therapies.
Methods: Patients with papillary thyroid cancer (PTC) in pathology were recruited, while those with MK influencing co-morbidities and with positive thyroglobulin antibodies were excluded. Concentrations of MK were measured by enzyme-linked immunosorbent assay. MK concentration at initial 131I ablation therapy (MK1) as well as 10-12 months thereafter (MK2) was evaluated. And the dynamic changes of thyroglobulin (Tg) were compared (Tg1 and Tg2) too. This study received our Institutional Ethics Approval. Results: There were 241 PTC patients (36 males, 205 females) enrolled, 55 cases had metastases (8 males, 47 females) during follow-up. Disease-free survival curves were drawn by Kaplan-Meier
Methods: For Tg, significantly higher cumulative rate of disease-free status was found if Tg could decrease to less than 1.0ng/ml under TSH stimulation, and the log-rank statistical value was 272.468. For MK, the same pattern was displayed with a log-rank statistical value of 112.740. Cox regression showed if Tg2 decreased (compared with Tg1), but not to less than 1.0ng/ml under TSH stimulation, the risk of metastases was 12.554 times more than if it could decrease to the optimal level. If Tg2 increased, the risk is 19.461 times higher. As for MK, if MK2 level decreased (compared with MK1), but not to a normal level, the risk of metastases is 3.006. If MK2 level increased, it would be 5.030 likely to had metastases. Conclusions: Our results indicated that MK could potentially be used as a disease monitoring biomarker for PTC, although inferior to Tg.
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