Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China.
Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun, Jilin, China.
PLoS One. 2018 Jun 27;13(6):e0198896. doi: 10.1371/journal.pone.0198896. eCollection 2018.
The prevalence of papillary thyroid carcinoma (PTC) is rising rapidly. However, there are no reliable serum biomarkers for PTC. This study aimed to investigate the validity of preoperative serum matrix metalloproteinase-2 (MMP-2) as a biomarker for predicting prognosis of PTC after total or partial thyroidectomy.
Male patients with PTC or a benign thyroid nodule (BTN) and healthy controls (HCs) were retrospectively included. Receiver operating characteristic (ROC) curves were constructed to evaluate the performance of preoperative serum MMP-2 in diagnosing PTC, predicting lymph node metastasis (LNM), and predicting structurally persistent/recurrent disease (SPRD). Multivariate logistic regression and Cox regression were applied to identify independent risk factors for SPRD.
The preoperative serum MMP-2 concentration in the PTC group was higher than those in BTN and HC groups. The concentration of postoperative serum MMP-2 decreased in comparison with pre-operation. ROC curves showed that serum MMP-2 could differentially diagnose PTC from BTN at the cutoff value of 86.30 ng/ml with an area under the curve (AUC) of 0.905 and could predict central LNM (CLNM) at the cutoff value of 101.55 ng/ml with an AUC of 0.711. Serum MMP-2 ≥101.55 ng/ml, age ≥45 years, and advanced TNM stage were independent risk factors for CLNM. Patients with SPRD had a higher median MMP-2 level (149.22 ng/ml) than patients without SPRD (104.55 ng/ml). Serum MMP-2 at the cutoff value of 144.04 ng/ml could predict SPRD in PTC patients with an AUC of 0.803. Advanced TNM stage and serum MMP-2 ≥144.04 ng/ml were independent risk factors for SPRD. Patients with serum MMP-2 ≥144.04 ng/ml had a worse clinical outcome than those with MMP-2 <144.04 ng/ml.
Preoperative serum MMP-2 may serve as a biomarker for diagnosing PTC and a predictive indicator for LNM and SPRD in male patients with PTC.
甲状腺乳头状癌（PTC）的发病率正在迅速上升。然而，目前尚无可靠的 PTC 血清生物标志物。本研究旨在探讨术前血清基质金属蛋白酶-2（MMP-2）作为预测 PTC 患者行甲状腺全/近全切除术后预后的有效性。
回顾性纳入男性 PTC 或良性甲状腺结节（BTN）患者及健康对照者（HC）。构建受试者工作特征（ROC）曲线以评估术前血清 MMP-2 对诊断 PTC、预测淋巴结转移（LNM）和预测结构持续/复发疾病（SPRD）的效能。多因素 logistic 回归和 Cox 回归分析用于识别 SPRD 的独立危险因素。
PTC 组患者术前血清 MMP-2 浓度高于 BTN 组和 HC 组，术后 MMP-2 浓度较术前下降。ROC 曲线显示，MMP-2 对 PTC 与 BTN 的鉴别诊断界值为 86.30ng/ml，曲线下面积（AUC）为 0.905，预测中央区 LNM（CLNM）的界值为 101.55ng/ml，AUC 为 0.711。血清 MMP-2≥101.55ng/ml、年龄≥45 岁、TNM 分期较晚是 CLNM 的独立危险因素。有 SPRD 的患者 MMP-2 中位数（149.22ng/ml）高于无 SPRD 的患者（104.55ng/ml）。MMP-2 界值为 144.04ng/ml 时可预测 PTC 患者的 SPRD，AUC 为 0.803。TNM 分期较晚和血清 MMP-2≥144.04ng/ml 是 SPRD 的独立危险因素。血清 MMP-2≥144.04ng/ml 的患者临床结局较 MMP-2<144.04ng/ml 的患者差。
术前血清 MMP-2 可能是男性 PTC 患者诊断 PTC 的生物标志物，也是 LNM 和 SPRD 的预测指标。
