Preoperative serum VEGF‐C but not VEGF‐A level is correlated with lateral neck metastasis in papillary thyroid carcinoma

Jang, Jeon Yeob; Kim, Deok-Soo; Park, Hee-Young; Shin, Sung‐Chan; Cha, Wonjae; Lee, Jin‐Choon; Wang, Soo-Geun; Lee, Byung‐Joo

doi:10.1002/hed.25729

Cited by 13 publications

(8 citation statements)

References 25 publications

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“…Previous studies have shown that with the growth of thyroid cancer, the vessels in the tumor are induced by angiogenic factors such as vascular endothelial growth factor (VEGF) and form a disordered vascular network ( 34 ). Studies have reported that the expression of VEGFR1 is an important predictor of lymph node metastasis, with one showing that NRP2 plays an important role in the regulation of VEGF-induced invasion and migration in vitro ( 35 ). With the increase in tumor angiogenesis, the contact between the active cells at the tumor margin and lymphatic vessels increases, making the tumor prone to metastasize into the lymphatic system.…”

Section: Discussionmentioning

confidence: 99%

Clinical Study of Ultrasonographic Risk Factors for Central Lymph Node Metastasis of Papillary Thyroid Carcinoma

Yang

Zhang

et al. 2021

Front. Endocrinol.

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BackgroundThyroid cancer is the most common malignancy of the endocrine system worldwide. Papillary thyroid cancer (PTC) is the most common pathologic type. The preoperative diagnosis of PTC and central lymph node metastasis (CLNM) or metastatic tendency is of great clinical significance to the diagnosis, treatment and prognosis of these patients. This study was conducted to investigate the correlation between ultrasound features and central CLNM of PTC.MethodsThis study retrospectively analyzed patients who underwent PTC surgery and central lymph node dissection in the Department of Surgery, Beijing Tiantan Hospital, from January 2019 to February 2020. According to the inclusion and exclusion criteria, data from 136 patients were ultimately included, and the clinical and ultrasonic data of the patients were analyzed by multivariate regression to evaluate the correlation among grayscale ultrasound (US), superb microvascular imaging (SMI) and contrast-enhanced ultrasound (CEUS) features of thyroid nodules and CLNM of PTCs.ResultsThe multivariate analysis showed that tumor size, multifocality, microcalcification characteristics, SMI vascularization, and CEUS evaluation of contact with the adjacent capsule were correlated with PTC metastasis (P=0.008, P=0.001, P=0.028, P=0.041, and P< 0.001, respectively). Comparisons of the area under the ROC curves revealed that the area under the ROC curve of the degree of nodular invasion into the thyroid capsule was the largest (AUC: 0.754). The sensitivity and specificity for evaluating CLNM of PTC were 67.7% and 83.1%, respectively.ConclusionsUltrasound characteristics of the following features are associated with a high risk of lymph node metastasis in PTCs: maximum diameter of nodules ≥1 cm, multifocality, ≥5 microcalcifications, abundant blood flow of SMI in nodules and nodule contact with the thyroid capsule ≥25% under CEUS. Ultrasound has clinical value in the preoperative evaluation of CLNM of PTCs.

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Section: Discussionmentioning

confidence: 99%

Clinical Study of Ultrasonographic Risk Factors for Central Lymph Node Metastasis of Papillary Thyroid Carcinoma

Yang

Zhang

et al. 2021

Front. Endocrinol.

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“…According to current guidelines, ultrasonography (US) is the main imaging method for preoperative evaluation of cervical lymph node metastasis of thyroid cancer (24). Jang et al found that the more abundant the blood supply of the tumor, the higher the probability of CLNM (25). In our study, there was a significant difference in blood flow signals between CLNM-positive patients and CLNM-negative patients.…”

Section: Discussionmentioning

confidence: 45%

Prophylactic central lymph node dissection performed selectively with cN0 papillary thyroid carcinoma according to a risk-scoring model

Zhong¹,

Lu²,

Yin³

et al. 2022

Gland Surg

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Background: This study aimed to explore the risk factors of central lymph node metastasis (CLNM) in patients with clinical central lymph node-negative papillary thyroid carcinoma (PTC), and emphasize the guidance of the risk scoring model for prophylactic central lymph node dissection (pCLND) in patients with clinical lymph node-negative (cN0) PTC. Methods: A total of 582 patients with cN0 PTC who underwent unilateral/bilateral thyroidectomy and prophylactic central lymph node dissection (pCLND) in the Affiliated Hospital of Nantong University from January 2020 to February 2021 were retrospectively analyzed. Univariate and multivariate analyses were performed to determine the risk factors of cN0 PTC. According to the independent risk factors of patients with cN0 PTC, a risk-scoring model was established. Then, the rationality of this risk scoring model was verified by additional clinical data of 112 patients with cN0 PTC in the Affiliated Hospital of Nantong University from March 2021 to April 2021.Results: Among 582 cases of cN0 PTC, 53.6% of the patients with cN0 had CLNM. The independent risk factors for CLNM in patients with cN0 PTC included male gender, <45 years of age, tumor with a maximum diameter of ≥1.0 cm, tumor location: middle/lower poles of the thyroid gland, multifocality, and extrathyroidal extension (ETE), and some ultrasound features, such as intra-nodular vascularity, microcalcification, irregular shape, and infiltrative margin. According to independent risk factors, a 24-point risk scoring model was established to predict CLNM in patients with cN0 PTC.Conclusions: Currently, prophylactic central neck lymph node dissection is a controversial operation, which should be selectively performed only for high-risk patients with cN0 PTC. For cN0 PTC patients with scores ≥14 and high-risk patients, even if no CLNM is found before surgery, routine prophylactic CLND is recommended. In addition, for cN0 PTC patients with a score of fewer than 14 points, it is recommended to perform fine-needle aspiration (FNA) before surgery, carefully assess the condition of the central lymph nodes, and then select the best surgical plan based on the results of the assessment.

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“…A number of previous studies have investigated whether quantifiable changes in protein expression can be used diagnostically or prognostically for thyroid malignancies, especially as biomarkers for disease characteristics such as lateral neck metastasis in thyroid cancer (11). As is the case for most cancers (>90% cancer-related deaths are due to tumour invasion), metastasis remains one of the main reasons for patient mortality in PTC (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…The expression of biomarkers within a tissue, although interesting from a biological perspective, commonly do not reflect the level within circulation (8), and it is clearly impractical to sample routinely making them less attractive for clinical utilisation. On the other hand, patient sera, potentially offer a higher degree of translatability for the identification of progression and disease-specific biomarkers (9)(10)(11); thus far both serum VEGF-C and MMP-2 have been correlated with thyroid tumour metastases (11,12).…”

Section: Introductionmentioning

confidence: 99%

Identification of soluble tissue‑derived biomarkers from human thyroid tissue explants maintained on a microfluidic device

et al. 2021

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Although a large cohort of potential biomarkers for thyroid cancer aggressiveness have been tested in various formats in recent years, to the best of our knowledge, thyroglobulin and calcitonin remain the only two established biomarkers associated with thyroid cancer management. Our group has recently validated a novel means of maintaining live, human ex vivo thyroid tissue within a tissue-on-chip format. The present pilot study aimed to interrogate the tissue effluent, containing all the soluble markers released by the tissue samples maintained within the devices' tissue chamber, for the presence of markers potentially associated with thyroid cancer aggressiveness. Culture effluent from tissue samples harvested from 19 individual patients who had undergone thyroidectomy for the treatment of suspected thyroid cancer was assessed, first using a proteome profiler™ angiogenesis array kit. Patients were subcategorised as 'aggressive' if they possessed a minimum of N1b level metastases, whilst 'non-aggressive' samples were T3 or lower without evidence of multifocality; and contralateral healthy thyroid tissue was harvested for comparative studies. Levels of Serpin-F1, vascular endothelial growth factor, Thrombospondin-1 and chemokine (C-C motif) ligand were significantly altered and, thus, were further investigated using ELISA to allow for quantitative analysis. The concentration of serpin-F1 was significantly increased in the effluent of aggressive thyroid cancer tissue when compared with levels released by both non-aggressive and benign samples. The present study demonstrated the usability of microfluidic technology for the analysis of the ex vivo tissue secretome in order to identify novel biomarkers.

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Preoperative serum VEGF‐C but not VEGF‐A level is correlated with lateral neck metastasis in papillary thyroid carcinoma

Cited by 13 publications

References 25 publications

Clinical Study of Ultrasonographic Risk Factors for Central Lymph Node Metastasis of Papillary Thyroid Carcinoma

Clinical Study of Ultrasonographic Risk Factors for Central Lymph Node Metastasis of Papillary Thyroid Carcinoma

Prophylactic central lymph node dissection performed selectively with cN0 papillary thyroid carcinoma according to a risk-scoring model

Identification of soluble tissue‑derived biomarkers from human thyroid tissue explants maintained on a microfluidic device

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