Abstract
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Objectives: To investigate the values of serum midkine (MK) and galectine-3 (Gal-3) as a diagnostic biomarker in thyroid cancer before the surgery, and analyze the ability of serum MK and Gal-3 to predict metastases before the first 131I treatment in differentiated thyroid cancer(DTC)patients after thyroidectomy.
Methods: A total of 42 patients (23 patients in malignant group and 19 patients in benign group) participated in the pre-surgical study. 32 healthy subjects served as controls. Diagnostic values of pre-surgical MK and Gal-3 for malignant thyroid nodule were conducted by receiver operating characteristic (ROC) curves. A total of 51 DTC patients participated in the prediction postoperative metastasis study. All of them had accepted the second 131I treatment, collected serum before the first iodine treatment and recorded as serum MK(A), Gal-3(A). According to whether there was lymph node, bone and/or lung metastasis, they were divided into metastasis positive group (8 cases) and negative group (43 cases). Independent two-sample t test or Mann-Whitney U test were used to analyze the data. Pearson correlation analysis was used to analyze the relationship between MK and Gal-3.
Results: Pre-surgical MK and Gal-3 levels were significantly higher in malignant thyroid nodule patients than those in benign and those in controls (Table 1, P<0.05). The ROC curve analysis determined the optimal value of MK and Gal-3 for differential diagnosis between malignant and benign thyroid nodules. The diagnostic power of MK was the highest at 318.87pg/mL; at that value, the AUC was 0.90±0.05 and it had 78.3% specificity, 88.2% sensibility( Figure 1). The diagnostic power of Gal-3 was the highest at 1.61 ng/mL; at that value, the AUC was 0.71±0.09 and it had 70.0% specificity, 69.6% sensibility( Figure 2). Tg, MK(A), Gal-3(A) in metastasis positive group were significantly higher in negative group and control group (Table 2, P<0.05), but not were significantly between negative group and control group. MK and Gal-3 were significantly correlated in pre-surgical and pre-131I-ablative (P<0.05).
Conclusions: Serum MK and Gal-3 had a some clinical value for identify the benign and malignant thyroid nodules before surgery and predict metastasis before the first 131I treatment in DTC patients after thyroidectomy.Key words :Thyroidneoplasms; Serum MK; Serum Gal-3; Diagnosis, differential; MetastasisTable 1. Serum markers comparisons between three groups before operation
[asterisk]: P<0.05, a: compare with malignancy group, P<0.05, b: compare with control group, P>0.05. Table 2. Serum markers comparisons between three groups before the first 131I treatment in DTC patients after thyroidectomy operation
[asterisk]: P<0.05; a:compare with metastasis positive group, P<0.05, b: compare with control group, P>0.05.
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