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三级转诊中心甲状腺结节患者甲状腺切除术前、术中和术后的促炎细胞因子

ProInflammatory Cytokines in Patients With Thyroid Nodules Before, During, and After Thyroidectomy in a Tertiary Referral Center.

作者信息

Jagannath Spandana, Sabaretnam Mayilvaganan, Chand Gyan, Mishra Anjali, Misra Durga Prasanna, Rai Mohit Kumar, Agarwal Gaurav

机构信息

Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

出版信息

World J Surg. 2025 Jul;49(7):1820-1827. doi: 10.1002/wjs.12643. Epub 2025 May 30.

Abstract

BACKGROUND

Thyroid nodules are epidemic in certain countries. Advancements in imaging technology and increased healthcare screening have led to a notable rise in their detection. This surge in detection has also sparked a renewed focus on understanding their pathophysiology. Limited research exists regarding involvement of proinflammatory cytokines in thyroid disorders. We studied the presence of these proinflammatory cytokines in preoperative serum samples from the tissue of interest (colloid) retrieved during surgery, and postoperative serum samples.

MATERIALS AND METHODS

We performed a prospective study including patients having solitary thyroid nodule (colloid goiter) undergoing surgery. A total of 3 mL each of preoperative serum sample, aspirated colloid from thyroid specimen, and postoperative serum sample 4 weeks after surgery were collected. The quantification of supernatant cytokines (IL-1, IL-4, IL-6, IL-10, IL-12, IL-17A, IFN-γ, TNF-α, and TGF-β) was done by ELISA. Standard protocols for ELISA were followed, and all assays were performed in duplicate to ensure accuracy.

RESULTS

The study included 40 patients with a median age of 32.5 years (27-48.5 years). The majority of our participants were female, reflecting the higher prevalence of thyroid nodules in women. On analyzing the levels of proinflammatory cytokines, significant differences were seen between the preoperative serum sample, colloid sample, and postoperative serum sample. Colloid had considerably higher levels of proinflammatory cytokines (IL-1, IL-4, IL-6, IL-10, IL-12, IL-17A, IFN-γ, TNF-α, and TGF-β) when compared to both pre- and postoperative serum samples (p < 0.05).

CONCLUSION

Markedly elevated levels of proinflammatory cytokines seen in colloid obtained during surgery compared to both the pre- and postoperative serum samples suggest that the inflammatory milieu of thyroid tissue is different to that of the systemic circulation. These findings provide a foundation for further research into the inflammatory mechanisms.

RESEARCH REGISTRY REGISTRATION

No: 8638 dated January 22, 2023.

摘要

背景

甲状腺结节在某些国家很常见。成像技术的进步和医疗筛查的增加导致其检出率显著上升。这种检出率的激增也引发了对其病理生理学理解的重新关注。关于促炎细胞因子参与甲状腺疾病的研究有限。我们研究了这些促炎细胞因子在手术中获取的感兴趣组织(胶体)的术前血清样本以及术后血清样本中的存在情况。

材料与方法

我们进行了一项前瞻性研究,纳入了接受手术的孤立性甲状腺结节(胶体性甲状腺肿)患者。分别收集术前血清样本、从甲状腺标本中吸出的胶体以及术后4周的血清样本各3 mL。通过酶联免疫吸附测定(ELISA)对上清液中的细胞因子(白细胞介素-1、白细胞介素-4、白细胞介素-6、白细胞介素-10、白细胞介素-12、白细胞介素-17A、干扰素-γ、肿瘤坏死因子-α和转化生长因子-β)进行定量。遵循ELISA的标准方案,所有检测均重复进行以确保准确性。

结果

该研究纳入了40例患者,中位年龄为32.5岁(27 - 48.5岁)。我们的大多数参与者为女性,这反映了女性甲状腺结节的患病率较高。在分析促炎细胞因子水平时,术前血清样本、胶体样本和术后血清样本之间存在显著差异。与术前和术后血清样本相比,胶体中的促炎细胞因子(白细胞介素-1、白细胞介素-4、白细胞介素-6、白细胞介素-10、白细胞介素-12、白细胞介素-17A、干扰素-γ、肿瘤坏死因子-α和转化生长因子-β)水平明显更高(p < 0.05)。

结论

与术前和术后血清样本相比,手术中获取的胶体中促炎细胞因子水平显著升高,这表明甲状腺组织的炎症环境与全身循环不同。这些发现为进一步研究炎症机制提供了基础。

研究注册

编号:2023年1月22日的8638号。

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