title: Midkine: A Novel Biomarker to Predict Malignancy in Patients with Nodular Thyroid Disease.
abstract: Background. Midkine (MK), a new heparin-binding growth factor, plays important roles in a variety of biological phenomena such as carcinogenesis, inflammation, and angiogenesis. In this study, we aimed to evaluate serum midkine (SMK) and nodular midkine (NMK) levels in patients with thyroid nodules to predict malignancy and whether there was any association between. Methods. A total of 105 patients (74 women, 31 men) with thyroid nodules were enrolled. The levels of SMK and NMK were measured. Any possible correlation between SMK, NMK, and biochemical, cytopathological, or radiological variables was investigated. Results. Both SMK and NMK were found to be higher in hypoechoic nodules with an irregular border and without a halo (p < 0.05). Serum MK levels were significantly higher in nodules with microcalcifications than nodules with macrocalcification or without calcification (p = 0.001). SMK levels were found to be correlated with NMK levels (SMK 0.63 ng/ml versus 1.04 ng/mL and NMK 0.55 ng/mL versus 0.55 ng/mL, r (2) = 0.54, p < 0.001). Conclusion. Both SMK and NMK can predict tumorigenesis of highly malignant/suspicious thyroid cytopathology and also well correlated with sonographic features of thyroid nodules. We suggest that MK levels may serve as an alternative biomarker, in conjunction with the cytopathological results in preoperative assessment of thyroid nodules.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Bulent Ecevit University, 67600 Zonguldak, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Kuzu
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Bulent Ecevit University, 67600 Zonguldak, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Arpaci
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Bulent Ecevit University, 67600 Zonguldak, Turkey.
authors.forename: Mustafa
authors.identifier: 0000-0001-6640-6298
authors.initials: M
authors.lastname: Unal
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Bulent Ecevit University, 67600 Zonguldak, Turkey.
authors.forename: Ayfer
authors.initials: A
authors.lastname: Altas
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Bulent Ecevit University, 67600 Zonguldak, Turkey.
authors.forename: Gürkan
authors.initials: G
authors.lastname: Haytaoglu
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Bulent Ecevit University, 67600 Zonguldak, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Can
authors.affiliation: Department of Pathology, Faculty of Medicine, Bulent Ecevit University, 67600 Zonguldak, Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Barut
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Bulent Ecevit University, 67600 Zonguldak, Turkey.
authors.forename: Furuzan
authors.initials: F
authors.lastname: Kokturk
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Bulent Ecevit University, 67600 Zonguldak, Turkey.
authors.forename: Sevil Uygun
authors.initials: SU
authors.lastname: Ilikhan
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Bulent Ecevit University, 67600 Zonguldak, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Bayraktaroglu