Operative Unit of Internal Medicine "G. Baccelli", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro" Medical School, Bari, Italy.
Academic General Surgery Unit, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro" Medical School, Bari, (BA), Italy.
Surgery. 2021 Jan;169(1):27-33. doi: 10.1016/j.surg.2020.03.031. Epub 2020 May 30.
Circulating angiogenic factors have been associated with clinical outcomes of papillary thyroid carcinoma, although they may also be released in the context of benign multinodular goiter. We sought to investigate the effect of thyroidectomy on the activity and importance of multiple circulating angiogenic factors in papillary thyroid carcinoma and benign multinodular goiter.
Between May 2015 and December 2016, patients scheduled for total thyroidectomy for papillary thyroid carcinoma or benign multinodular goiter were offered to enroll in this study. Serum levels of angiopoietin-2, fibroblast growth factor-2, hepatocyte growth factor, platelet-derived growth factor-BB, placenta growth factor, heparin-binding epidermal growth factor, and vascular endothelial growth factor-A and -C were collected preoperatively and 2 weeks postsurgery. These levels were measured by enzyme-linked immunosorbent assay and compared with those of 35 healthy control subjects.
Sixty patients with a median age of 52 years, 37 of whom were females, were included: 36 had papillary thyroid carcinoma, and 24 had benign multinodular goiter. In both benign multinodular goiter and papillary thyroid carcinoma, preoperative, circulating angiogenic factors levels were increased with respect to controls (P < .0001), and a decrease after total thyroidectomy was observed in the levels of angiopoietin-2 (P < .0001), fibroblast growth factor-2 (P < .0001), hepatocyte growth factor (P < .001), and heparin-binding epidermal growth factor (P < .01 each). Only patients with papillary thyroid carcinomas, however, showed decrease in the postoperative levels of platelet-derived growth factor-BB and vascular endothelial growth factor-A (P = .001 each).
Results from this study raise the potential for vascular endothelial growth factor-A and platelet-derived growth factor-BB to be used as biomarkers of the effectiveness of treatment of papillary thyroid carcinoma. These results warrant further investigation and may have potential prognostic implications.
循环血管生成因子与甲状腺乳头状癌的临床结果相关，尽管它们也可能在良性多结节性甲状腺肿的情况下释放。我们试图研究甲状腺切除术对甲状腺乳头状癌和良性多结节性甲状腺肿中多种循环血管生成因子的活性和重要性的影响。
在 2015 年 5 月至 2016 年 12 月期间，为因甲状腺乳头状癌或良性多结节性甲状腺肿接受甲状腺全切除术的患者提供了入组本研究的机会。术前采集血管生成素-2、成纤维细胞生长因子-2、肝细胞生长因子、血小板衍生生长因子-BB、胎盘生长因子、肝素结合表皮生长因子、血管内皮生长因子-A 和 -C 的血清水平，并在术后 2 周进行测量。通过酶联免疫吸附试验进行测量，并与 35 名健康对照者进行比较。
共纳入 60 名中位年龄为 52 岁的患者，其中 37 名为女性：36 名患有甲状腺乳头状癌，24 名患有良性多结节性甲状腺肿。在良性多结节性甲状腺肿和甲状腺乳头状癌中，术前循环血管生成因子水平均高于对照组（P <.0001），甲状腺全切除术后，血管生成素-2（P <.0001）、成纤维细胞生长因子-2（P <.0001）、肝细胞生长因子（P <.001）和肝素结合表皮生长因子（P <.01）水平下降。然而，只有甲状腺乳头状癌患者术后血小板衍生生长因子-BB 和血管内皮生长因子-A 水平下降（P 分别为.001）。
本研究结果提示血管内皮生长因子-A 和血小板衍生生长因子-BB 可能作为甲状腺乳头状癌治疗效果的生物标志物。这些结果需要进一步研究，可能具有潜在的预后意义。
