Value of serum miR-599 combined with VEGF in predicting recurrence of patients with differentiated thyroid cancer after subtotal resection
Objective To investigate the efficacy of serum microRNA-599(miR-599)and vascular endothelial growth factor(VEGF)levels in the prediction of recurrence of patients with differentiated thyroid cancer(DTC)after totally endoscopic subtotal thyroidectomy.Methods A total of 135 patients with DTC who underwent totally endoscopic subtotal thyroidectomy at Tongchuan People's Hospital from January 2017 to March 2022 were selected.The serum levels of miR-599 and VEGF in all the patients were detected before the operation.Their preoperative clinical data were collected.The patients were followed up for 2 years after the operation.According to the postoperative recurrence,they were divided into a recurrence group(31 cases)and a non-recurrence group(104 cases).There were 12 men and 19 women in the recurrence group;they were(51.26±7.32)years old.There were 48 men and 56 women in the non-recurrence group;they were(49.57±7.08)years old.The count data were analyzed by x2 test or Fisher's exact probability test.The measurement data were analyzed by the independent-sample t test.The influencing factors of postoperative recurrence were analyzed by the multivariate stepwise logistic regression model.The predictive efficacies of serum miR-599 and VEGF levels in predicting postoperative recurrence were analyzed by the areas(AUC)under the receiver operating characteristic curves(ROC).Results The level of miR-599 in the recurrence group was lower than that in the non-recurrence group[(0.81±0.09)vs.(1.05±0.12)],and the level of VEGF in the recurrence group was higher than that in the non-recurrence group[(32.55±5.26)ng/L vs.(24.83±4.07)ng/L](t=10.295 and 8.639;both P＜0.001).The proportion of the patients of Ⅲ-Ⅳ stage[67.74％(21/31)vs.28.85％(30/104)]and anti-thyroglobulin antibody(TgAb)level[(251.86±27.98)IU/ml vs.(211.43±23.49)IU/ml]in the recurrence group were higher than those in the non-recurrence groupm,and the proportions of the patients taking intraoperative lymph node dissection[22.58％(7/31)vs.44.23％(46/104)]and postoperative radioactive iodine therapy[32.26％(10/31)vs.53.85％(56/104)]in the recurrence group were lower than those in the non-recurrence group(t=8.040;x2=4.694 and 4.454;all P＜0.05).The multivariate stepwise logistic regression analysis showed that the level of miR-599(OR=0.251,95％CI 0.109-0.576)was an independent protective factor for postoperative recurrence,and the level of VEGF(OR=2.163,95％CI 1.256-3.722),clinical stage(OR=4.287,95％CI 1.908-9.631),and TgAb level(OR=4.612,95％CI 2.172-9.789)were independent risk factors for postoperative recurrence(all P＜0.05).The ROC showed that the sensitivities of miR-599,VEGF,and their combination in the prediction of postoperative recurrence were 71.00％,74.20％,and 90.30％,respectively;the specificities were 76.90％,72.10％,and 88.50％,respectively;the AUC's were 0.824,0.794,and 0.931,respectively(all P＜0.05).Conclusions Serum VEGF level is an independent risk factor for recurrence,and serum miR-599 level is an independent protective factor for recurrence in DTC patients after total endoscopic subtotal thyroidectomy.The combined detection of the two markers can better predict the risk of postoperative recurrence.
万方数据
维普
