血清VEGF-C、VEGF-D及VEGFR-3联合TSH检测在甲状腺乳头状癌诊断中的价值  

Value of VEGF-C,VEGF-D and VEGFR-3 levels combined with serum TSH in diagnosis of papillary thyroid carcinoma

作　　者：黄静[1] 李燕萍[2] 薛刚[2] 张文静[3] 李少英[3] 张静[3] 吴靖芳[3] 

机构地区：[1]河北北方学院2010临床5班,张家口075000 [2]河北北方学院附属第一医院耳鼻咽喉头颈外科,张家口075000 [3]河北北方学院组胚教研室,河北张家口075000

出　　处：《南方医科大学学报》2014年第12期1814-1817,1821,共5页Journal of Southern Medical University

基　　金：河北省教育厅重点项目(ZD2010101);河北省科技厅项目(12276104D-91);河北北方学院重大项目(ZD201315)

摘　　要：目的探讨甲状腺乳头状癌患者血清VEGF-C、VEGF-D和VEGFR-3的表达水平,分析3个指标与临床病理和甲状腺功能的关系。方法收集就诊于河北北方学院附属第一医院的甲状腺疾病患者的血清及甲功资料。其中甲状腺乳头状癌(PTC)55例,甲状腺良性肿瘤(BT)24例。采用酶联免疫吸附法检测血清VEGF-C/D和VEGFR-3浓度,并分析每位患者上述3个指标与甲状腺功能的关系。结果 PTC组血清VEGF-C和VEGFR-3浓度明显高于BT组(P<0.05);VEGF-D浓度在两组间差异无统计学意义(P>0.05)。PTC患者血清VEGF-C和VEGFR-3浓度在临床Ⅲ/Ⅳ期高于Ⅰ/Ⅱ期、TSH升高组明显高于TSH正常组、年龄>45岁者明显高于≤45岁者、肿瘤直径>2 cm的患者明显高于≤2 cm的患者(P<0.05或P<0.01),VEGF-C和VEGFR-3在有无淋巴结转移组变化不一致,淋巴结转移组VEGF-C浓度明显高于无转移组,而VEGFR-3则低于无转移组;二者均与性别无关;血清VEGF-D浓度在PTC伴淋巴结转移组明显高于无转移组、TSH升高组明显高于正常组(P<0.05或P<0.01),与临床分期、肿瘤直径以及年龄、性别均无关。血清VEGF-C、VEGFR-3和TSH浓度的ROC曲线及线下面积分别为0.803,0.734和0.707(P<0.01);VEGF-D浓度线下面积0.556(P>0.05)。联合VEGF-C、VEGFR-3和TSH三个指标线下面积0.862(P<0.01)。结论联合检测血清VEGF-C和VEGFR-3的表达水平并结合患者的TSH结果,可以提高甲状腺乳头状癌的早期诊断率。Objective To investigate serum vascular endothelial growth factor-C （VEGF-C）, VEGF-D and VEGFR-3 levels in patients with papillary thyroid carcinoma （PTC） and analyze their relation with the clinicopathological and thyroid function of the patients. Methods Serum samples and the data of thyroid function were collected from 55 patients with PTC and 24 with benign thyroid tumor （BT）. ELISA was used to detect VEGF-C/D and VEGFR-3 concentration in the serum samples and their relation with the thyroid function was analyzed. Results The VEGF-C and VEGFR-3 levels were significantly higher in PTC group than in BT group （P〈0.05）, but VEGF-D level was comparable between them （P〉0.05）. In PTC patients, the elevation of serum VEGF-C and VEGFR-3 levels was associated with an advanced clinical stage （III-IV）, elevated thyroid-stimulating hormone （TSH） level, an age over 45 years, and a tumor diameter exceeding 2 cm （P〈0.05 or P〈0.01）. Patients with lymph node metastasis had significantly higher VEGF-C level but lower VEGF-3 level than those without metastasis regardless of gender. Serum VEGF-D level was higher in PTC patients with lymph node metastasis （P〈0.05） and elevated TSH level （P〈0.01） without association with the clinical stage, tumor diameter, age, or gender. The area under ROC curve （AUC） of serum VEGF-C, VEGFR-3 and TSH was 0.803, 0.734 and 0.707 respectively （P〈0.01）, and that of VEGF-D was 0.556 （P〉0.05）;when combined, serum VEGF-C, VEGFR-3 and TSH showed an AUC of 0.862 （P〈0.01）. Conclusion Detecting serum VEGF-C and VEGFR-3 levels combined with TSH may enhance the early diagnosis rate of papillary thyroid carcinoma.

关 键 词：甲状腺乳头状癌 淋巴结转移 VEGFR-3 酶联免疫吸附试验 

分 类 号：R736.1[医药卫生—肿瘤]