title: Serum midkine as a surrogate biomarker for metastatic prediction in differentiated thyroid cancer patients with positive thyroglobulin antibody.
abstract: Serum thyroglobulin (Tg) is the main post-operative tumor biomarker for patients with differentiated thyroid cancer (DTC). However, the presence of thyroglobulin antibodies (TgAb) can interfere with Tg level and invalidate the test. In this study, we aimed to investigate the predicative value of midkine (MK) as a cancer biomarker for DTC patients with positive TgAb before the first131I therapy. MK levels were measured by enzyme-linked immunosorbent assay in 151 recruited DTC patients after exercising strict inclusion and exclusion criteria. There were 28 TgAb positive DTC patients with metastases and 123 DTC patients without metastases. The value of pre-131I-ablative MK to predict metastasis was assessed by receiver operating characteristic (ROC) curves in these two groups of patients. MK levels in the TgAb positive DTC patients were significantly higher than the DTC patients without metastases. ROC showed good predictability of MK, with an area under the curve of 0.856 (P < 0.001), and a diagnostic accuracy of 83% at the optimal cut-off value of 550 pg/ml. In conclusion, we show that MK can potentially be used as a surrogate biomarker for predicting DTC metastases when Tg is not suitable due to TgAb positivity.
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Jia
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Zhaowei
authors.initials: Z
authors.lastname: Meng
authors.affiliation: Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Micro-environment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Xianghui
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Tan
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Guizhi
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Xue
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Na
authors.initials: N
authors.lastname: Liu
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Tianpeng
authors.initials: T
authors.lastname: Hu
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Pingping
authors.initials: P
authors.lastname: Zhou
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Sen
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Arun
authors.initials: A
authors.lastname: Upadhyaya
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Huiying
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D014408:Biomarkers, Tumor; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D000078792:Midkine; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve; D013964:Thyroid Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D014408:Biomarkers, Tumor; D036341:Intercellular Signaling Peptides and Proteins; D007457:Iodine Radioisotopes; C006606:anti-thyroglobulin; D000078792:Midkine