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Zhou L, Jiang J, Fu Y, Zhang D, Li T, Fu Q, Yan C, Zhong Y, Dionigi G, Liang N, Sun H. Diagnostic performance of Midkine ratios in fine-needle aspirates for evaluation of Cytologically indeterminate thyroid nodules. Diagn Pathol 2021; 16:92. [PMID: 34689799 PMCID: PMC8543763 DOI: 10.1186/s13000-021-01150-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/21/2021] [Indexed: 11/20/2022] Open
Abstract
Background Fine-needle aspiration cytology (FNAC) is a basic diagnostic tool for thyroid nodules. However, 15–30% of nodules are cytologically indeterminate. Midkine (MK), a pleiotropic growth factor, is often upregulated in patients with cancers. This study aimed to evaluate the role of MK and its ratios in fine-needle aspirates (FNA) for predicting thyroid malignancy. Methods This retrospective study included patients with thyroid nodules who underwent preoperative FNA and/or thyroidectomy between April 2017 and September 2017. MK levels in FNA washout were measured by enzyme-linked immunosorbent assay, and thyroglobulin (TG) and free thyroxine (FT4) levels in FNA washout were measured by chemiluminescent immunometric assays. Results A total of 217 patients with 242 nodules were included in this study. The concentrations of TG, FT4, MK/TG, MK/FT4, and FT4/MK were significantly different between papillary thyroid carcinomas and benign thyroid nodules. Both MK/TG and MK/FT4 ratios were positively correlated with maximum tumor diameter, extrathyroidal extension, and T and N stages. The area under the curve for MK/TG was 0.719 with a cutoff value of 55.57 ng/mg, while the area under the curve for MK/FT4 was 0.677 with a cutoff value of 0.11 μg/pmol. FNAC in combination with MK/FT4 had a higher sensitivity (95% vs. 91%) and accuracy (96% vs. 92%) than FNAC alone for cytologically indeterminate specimens, those of unknown significance, or those suspected of malignancy. Conclusions MK/FT4 and MK/TG may have diagnostic utility for evaluation of papillary thyroid carcinomas, particularly for cytologically indeterminate thyroid nodules. Supplementary Information The online version contains supplementary material available at 10.1186/s13000-021-01150-y.
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Affiliation(s)
- Le Zhou
- Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, The China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun City, 130033, Jilin Province, China
| | - Jinxi Jiang
- Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, The China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun City, 130033, Jilin Province, China
| | - Yantao Fu
- Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, The China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun City, 130033, Jilin Province, China
| | - Daqi Zhang
- Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, The China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun City, 130033, Jilin Province, China
| | - Tong Li
- Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, The China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun City, 130033, Jilin Province, China
| | - Qingfeng Fu
- Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, The China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun City, 130033, Jilin Province, China
| | - Chao Yan
- Division Of Laboratory Medicine Center, The China-Japan Union Hospital of Jilin University, Changchun City, Jilin Province, China
| | - Yifan Zhong
- Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, The China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun City, 130033, Jilin Province, China
| | - Gianlorenzo Dionigi
- Division of General and Endocrine Surgery, Istituto Auxologico Italiano IRCCS, Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Nan Liang
- Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, The China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun City, 130033, Jilin Province, China.
| | - Hui Sun
- Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, The China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun City, 130033, Jilin Province, China.
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Wang W, Chang J, Jia B, Liu J. The Blood Biomarkers of Thyroid Cancer. Cancer Manag Res 2020; 12:5431-5438. [PMID: 32753960 PMCID: PMC7351621 DOI: 10.2147/cmar.s261170] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/20/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction With the gradual increase in the incidence of thyroid cancer, people’s attention to thyroid cancer has also gradually increased. Although the prognosis of thyroid cancer is rather mild compared to other cancers, it will still bring a heavy psychological burden on people who have been diagnosed. At present, the diagnosis of thyroid cancer mainly depends on ultrasound and percutaneous fine needle aspiration (pFNA). Due to the unsatisfactory accuracy of the diagnosis methods we use now, there are still some thyroid nodules that cannot be clearly diagnosed before surgery. Methods In this article, we have searched for relevant research on blood markers of thyroid cancer in the past five years and categoried them into four groups. Discussion Though we have not found a biomarker which can diagnose thyroid cancer both sensitively and specifically, we do found many substances that are related to it, and have the potential to recognize it and help the diagnosis. And perhaps combined models can do it better.
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Affiliation(s)
- Weiran Wang
- First Hospital of Shanxi Medical University, General Surgery Department, Taiyuan, Shanxi, People's Republic of China
| | - Jingtao Chang
- First Hospital of Shanxi Medical University, General Surgery Department, Taiyuan, Shanxi, People's Republic of China
| | - Baosong Jia
- First Hospital of Shanxi Medical University, General Surgery Department, Taiyuan, Shanxi, People's Republic of China
| | - Jing Liu
- First Hospital of Shanxi Medical University, General Surgery Department, Taiyuan, Shanxi, People's Republic of China
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Xiao Q, Jia Q, Tan J, Meng Z. Serum biomarkers for thyroid cancer. Biomark Med 2020; 14:807-815. [PMID: 32677454 DOI: 10.2217/bmm-2019-0578] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/16/2020] [Indexed: 12/30/2022] Open
Abstract
The high prevalence of thyroid cancer requires a reliable serum biomarker for diagnosis and prognostic monitoring. Serum thyroglobulin has been established as the primary postoperative and postablative monitoring biomarker for this malignancy. However, the presence of thyroglobulin antibody imposes a significant interference on its overall management, which cannot be diminished by currently available assays. Trends on the level of the thyroglobulin antibody during follow-up is considered as a surrogate biomarker, but controversy exists. A variety of alternative biomarkers are being proposed and investigated, nevertheless, clinical trials and prospective validations are needed before they can be regarded as clinically viable serum parameters for thyroid cancer.
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Affiliation(s)
- Qian Xiao
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Qiang Jia
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Jian Tan
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, PR China
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Li N, Zhang C, Meng Z, Xu K, He X, Yu Y, Jia Q, Li X, Liu X, Wang X. Changes of serum midkine as a dynamic prognostic factor to monitor disease status in papillary thyroid cancer. Medicine (Baltimore) 2018; 97:e12242. [PMID: 30200153 PMCID: PMC6133610 DOI: 10.1097/md.0000000000012242] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This study aimed to investigate the value of dynamic changes of midkine (MK) to monitor post-surgical patients with papillary thyroid cancer (PTC) who were managed with I therapies.MK concentration at initial I ablation therapy (MK1) as well as 10 to 12 months thereafter (MK2) was evaluated. And the dynamic changes of thyroglobulin (Tg) were compared (Tg1 and Tg2). Patients with MK influencing co-morbidities and with positive thyroglobulin antibodies were excluded. Concentrations of MK were measured by enzyme-linked immunosorbent assay.There were 241 PTC patients (36 males, 205 females) enrolled, 55 cases had metastases (8 males, 47 females) during their follow-up. 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.Our results indicated that MK could potentially be used as a disease monitoring biomarker for PTC, although inferior to Tg.
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Affiliation(s)
- Ning Li
- Department of Nuclear Medicine
| | | | | | - Ke Xu
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Micro-environment, Tianjin Lung Cancer Institute
| | - Xianghui He
- Department of General Surgery, Tianjin Medical University General Hospital
| | - Yang Yu
- Department of Thyroid and Neck Tumor, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R. China
| | | | - Xue Li
- Department of Nuclear Medicine
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