| ObjecctiveTo investigate the clinical significance of YKL-40 in differential diagnosis of papillary thyroid carcinoma(PTC) and benign nodules through comparing the serum and tissue YKL-40 in all groups.Research design and methods1. Study object:The 40 inpatients with malignant throid nodules(all PTC) and 40 inpatients with benign thyroid nodules(nodular thyroid goiter and thyroid adenoma) were divided into two groups,and all of them were inpatients who visited general surgery of Qilu Hospital from August 2010 to January 2011.The 31 healthy subjects were into control group,matched age,sex with tumor groups.2. Clinical data:Collecting the clinical information such as age,sex,the history,size of thyroid and the family hitory of thyroid disease etc.Recording the performance of the thyroid color Doppler and lymphoid metastasis.After an overnight fast,peripheral venous blood samples of all inpatients were collected to test the YKL-40, the free serum triiodothyronine (FT3),free thyroxin (FT4),thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb) before the operation.In addition, The qualitative test of tissue YKL-40 was assayed in 21 malignant and 17 benign postsurgical specimens.3. Statistical analyses:The data management of statistical analyses was done by the SPSS statistical Package(Version 17.0).Continuous variables were presented as mean±standard deviation (x±s). Parameters between the two groups were used to compare two independent groups samples t test.Parameters among the groups were used to compare independent groups samples ANOVA process.Enumeration data was compare with Mann-Whitney-U-Wikipedia.ANOVA process was used to assess the association of serum YKL-40 with tissue YKL-40 in PTC.In all analysis p value less than 0.05 is considered to reach statistical significance (p<0.05)Resultsl.The level of serum YKL-40The serum YKL-40 level of malignant group,benign group and control group is 242.6363±62.5108pg/ml,235.1440±72.0791 pg/ml,241.1722±50.6869pg/ml,respectively.Significantly difference was not found among three groups (P=0.857).In the malignant group,the serum YKL-40 level of individuals with or without lymphnode metastasis is 260.6933±80.3858pg/ml,234.8975±52.9590 pg/ml, respectively.There is no significantly difference between two groups either (P=0.236).2.The level of tissue YKL-402.1 CriterionImmunoreactivity was scored using a semi-quantitative method. a:By evaluating the heterogeneous positive distribution,we classified all cases into four categories:(1) less than 1%10%positive epithelial cells;(2) from 11 to 50% positive;(3) from 51 to 80% positive;(4) from 80 to100% positive.b:By evaluating the color of the cells, we classified all cases into three categories:(1)yellow,(2)brown and (3)tan. And then the final score is a+b:0 is (-),1-2 is (+),3-5is (++),6-7 is (+++).2.2 AnalysisFor both groups,the YKL-40 is expressed in cytoplasm. In the malignant group: (-):0, (+):10 (47.6%), (++):8 (38.1%), (+++):3 (14.3%);In the benign group:(-):0, (+):15 (88.2%),(++):2 (11.8%),(+++).O.There is a significantly difference in tissue YKL-40 between two groups (P=0.008<0.05)3.There is no correlation between serum and tissue YKL-40 (P=0.836) in PTC.Conclusions 1. The test of serum YKL-40 can not serve in differential diagnosis of PTC and benign thyroid nodules, and serum YKL-40 level also can not be a predictor of lymph metastasis.2. Tissue YKL-40 is higher expressed in PTC than in benign thyroid nodules.The strong positive can indicate the diagnosis of malignant nodules.This predicts that the FNAC jointing YKL-40 may be a way to differential diagnosis of PTC and benign thyroid nodules.3. There is no reference between the serum and tissue YKL-40 in thyroid nodules (P=0.596)... |
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