Xu Dahai, Su Chang, Guo Liang, Yan He, Wang Shaokun, Yuan Congwang, Chen Guohui, Pang Li, Zhang Nan
Department of Emergency, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130021,China.
Department of Thyroid Surgery, the First Hospital of Jilin University, Changchun, Jilin, 130021, China.
Open Life Sci. 2019 Jul 10;14:275-287. doi: 10.1515/biol-2019-0031. eCollection 2019 Jan.
The incidence of papillary thyroid carcinoma (PTC) is increasing, and there are no reliable serum biomarkers for the diagnosis and prognosis of PTC. This study aimed to assess whether serum matrix metalloproteinase-9 (MMP-9) could serve as an auxiliary diagnostic/prognostic marker for PTC after total and partial thyroidectomy.
Postoperative serum MMP-9 concentrations were measured in 182 male patients with PTC, 86 male patients with benign thyroid nodule (BTN), and 62 male healthy controls (HCs). Multivariate logistic regression and Cox regression were applied to evaluate the correlation between variables. The performance of serum MMP-9 in diagnosing PTC and predicting structural persistent/recurrent disease (SPRD) during 48 months of follow-up after initial surgery was evaluated by receiving operating characteristic curve analysis.
The median serum MMP-9 concentration in the PTC group (79.45 ng/ml) was significantly higher than those in the BTN group (47.35 ng/ml) and HC group (47.71 ng/ml). The area under the curve (AUC) for predicting PTC from BTN was 0.852 at a cut-off value of 60.59 ng/ml. Serum MMP-9 was negatively correlated with disease-free survival (OR 1.026, P=0.001). Serum MMP-9 exhibited good performance in predicting SPRD at a cutoff value of 99.25 ng/ml with an AUC of 0.818. Advanced TNM stage (OR 31.371, P=0.019) and serum MMP-9 ≥99.25 ng/ml (OR 4.103, P=0.022) were independent risk factors for SPRD.
Serum MMP-9 potentially represents a good predictive biomarker for PTC diagnosis and prognosis after thyroidectomy in Chinese male patients for whom radio-imaging indicates suspected PTC.
甲状腺乳头状癌（PTC）的发病率正在上升，且尚无可靠的血清生物标志物用于PTC的诊断和预后评估。本研究旨在评估血清基质金属蛋白酶-9（MMP-9）能否作为全甲状腺切除和部分甲状腺切除术后PTC的辅助诊断/预后标志物。
测定了182例男性PTC患者、86例男性良性甲状腺结节（BTN）患者和62例男性健康对照者（HCs）术后血清MMP-9浓度。应用多因素逻辑回归和Cox回归评估变量之间的相关性。通过接受操作特征曲线分析，评估血清MMP-9在诊断PTC以及预测初次手术后48个月随访期间结构性持续/复发性疾病（SPRD）方面的性能。
PTC组血清MMP-9浓度中位数（79.45 ng/ml）显著高于BTN组（47.35 ng/ml）和HC组（47.71 ng/ml）。以60.59 ng/ml为临界值时，从BTN中预测PTC的曲线下面积（AUC）为0.852。血清MMP-9与无病生存期呈负相关（OR 1.026，P = 0.001）。以99.25 ng/ml为临界值时，血清MMP-9在预测SPRD方面表现良好，AUC为0.818。晚期TNM分期（OR 31.371，P = 0.019）和血清MMP-9≥99.25 ng/ml（OR 4.103，P = 0.022）是SPRD的独立危险因素。
对于影像学提示疑似PTC的中国男性患者，血清MMP-9可能是甲状腺切除术后PTC诊断和预后的良好预测生物标志物。
