The Different Serum Vascular Endothelial Growth Factor Levels After¹³¹I Treatment OF Differentiated Thyroid Carcinoma

OBJECTIVE:Thyroid carcinoma was the most common malignant tumor of the endocrine system, and its incidence had increased significantly during the past decades. Differentiated Thyroid Carcinoma(DTC) was the most frequent thyroid cancer histotype, accounting for about90%of malignant neoplasms of the thyroid gland. Tumor spread through the bloodstream or lymphatic channels, before which, tumor angiogenesis was the essential step, which provided the tumor cell to enter bloodstream or lymphatic channels. Vascular endothelial growth factor (VEGF) was the most important stimulant in the proliferation and migration of vascular endothelial cell. It had been reported that the serum VEGF levels in thyroid carcinoma patients were apparently higher than healthy controls. We analysed the serum VEGF levels in DTC patients who underwent131Iodine treatment and compared the differences of serum VEGF levels before131Iodine treatment between different groups(metastatic group and nonmetastatic group), to identify the clinical value of serum VEGF levels in the metastasis and the effect assessment of131Iodine treatment of DTC patients.METHODS:The records of80DTC patients who underwent131Iodine treatment in endocrine department of Qilu Hospital of Shandong University from March2011to October2011were reviewed, including29males and51females, which ranged from9to70years old, whose average age was42.3. Meanwhile, all patients were diagnosed with DTC by pathological examination, including76patients (95%) with papillary thyroid carcinoma (PTC) and4patients (5%) with follicular thyroid carcinoma (FTC). Besides, any diseases which could affect the serum VEGF levels were excluded according to physical examination and laboratory examination, including hypertension, diabetes mellitus, coronary heart disease, chronic obstructive pulmonary disease, autoimmune diseases, peripheral arteriosclerosis, infection(including rheumatoid arthritis), and platelet abnormality. The free serum triiodothyronine (FT3), free thyroxin (FT4),thyroid stimulating hormone(TSH), thyroglobulin (Tg), thyroglobulin antibody (TGAb) were routinely detected before and after idodine treatment. Moreover, the whole body was detected by ECT carried from5to7days after131Iodine treatment, and all patients were divided into a metastatic group and a nonmetastatic group according to the results of ECT. The metastatic group contianed34patients(31patients with cervical lymph nodes metastasis,11patients with mediastinal lymph nodes metastasis,5patients with lung metastasis), and the nonmetastatic group contained46patients. The serum VEGF levels were detected by enzyme-linked immunosorbent assay (ELISA) before and at the45th day after131Iodine treatment, respectively. The differences of serum VEGF levels between before and after131Iodine treatment, and different groups(metastatic group and nonmetastatic group) were compared by statistical method.RESULTS:l.The serum VEGF level of DTC patients after131Iodine treatment was356.46±225.11pg/ml, which was significantly lower than that(394.89±260.65pg/ml) before131Iodine treatment. There was significant difference between these two groups (P＜0.05)2.The serum VEGF level of metastatic group before131Iodine treatment was374.95±265.30pg/ml, and the serum VEGF level of nonmetastatic group before131Iodine treatment was409.62±259.11pg/ml. There was no significant difference between these two groups (P＞0.05) CONCLUSIONS:This study detects the change of serum VEGF level s of DTC patients after131Iodine treatment and investigates the influencing factors preliminarily.The data show that the serum VEGF levels of DTC patients after131Iodine treatment were significantly lower than those before131Iodine treatment.1.It is meaningful for DTC patients to detect the serum VEGF levels,evaluating the clinical effect of131Iodine treatment.Monitoring the variation of serum VEGF levels regularly might become a simple and dependable means to evaluate the effect of131Iodine treatment and prognosis of DTC patients.2.There is no sufficient evidence is proveded to judge the metastasis or not of DTC through detecting the serum VEGF levels.