Abstract
ObjectiveThe 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.MethodsMale 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.ResultsThe 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.ConclusionPreoperative serum MMP-2 may serve as a biomarker for diagnosing PTC and a predictive indicator for LNM and SPRD in male patients with PTC.
Highlights
Papillary thyroid carcinoma (PTC) is the predominant histological type of thyroid malignancy, accounting for 80%–85% of cases [1,2]
Receiver operating characteristic (ROC) curves were constructed to evaluate the performance of preoperative serum matrix metalloproteinase-2 (MMP-2) in diagnosing PTC, predicting lymph node metastasis (LNM), and predicting structurally persistent/recurrent disease (SPRD)
ROC curves showed that serum Matrix metalloproteinases (MMPs)-2 could differentially diagnose PTC from benign thyroid nodule (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
Summary
Papillary thyroid carcinoma (PTC) is the predominant histological type of thyroid malignancy, accounting for 80%–85% of cases [1,2]. Previous studies always focused on female patients with PTC. Differentiated PTC carries a favorable prognosis, it causes a postoperative recurrence rate as high as 30% during long-term follow-up [3]. A few biomarkers have been identified for the diagnosis of PTC, including EHD2 [4], Notch signaling [5], HER-2/neu [6], and CXCL12 [7], without clear evidence of their efficacy for clinical use. The identification and validation of reliable biomarkers for diagnostic and prognostic prediction of PTC is urgently needed in clinical work
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