The Serum Metabolomics Research Of Pre-operation And Post-operation In Patients With Papillary Thyroid Carcinoma

Objective: Analysis of the differences between preoperative andpostoperative in thyroid papillary carcinoma patients with differentsurgical method by serum nuclear magnetic resonance hydrogen spectrummetabonomics and provide reliable clinical basis for the thyroid papillarycarcinoma operation method choice.Methods:1.According to the inclusion criteria to collection preop-erative serum specimens of papillary thyroid carcinoma (PTC) patient,a totalof40cases.There are20cases(T1group）with unilateral thyroid resection.20case (T2group)with Total thyroidectomy.2.Unitil the postoperative patients taking thyroxine tablet regularly3months and collect their serum，a total of40cases.There are20cases(L1group）with unilateral thyroid resection.20case (L2group) with Total thyroi-dectomy.3.Analysis the serum specimen of above eighty patients with SwitzerlandBruker500Hz NMR.4、To phase and baseline correction use Topspin (2.1)software,to integraluse AMIX software (V3.9.11) between0.50-9.0ppm after calibration of thespectra,the width is0.005ppm.5、Analysis the differences about endogenous metabolites between thePreoperative group and Postoperative group、Bilateral group and Unilateralby PCA and PLS-DA with SIMCA-P+. Schematic diagram:Results:T1group vs L1group： relative with preoperative the patientsof thyroid papillary carcinoma with unilateral thyroid lobectomy, lacticacid, creatinine, postoperative succinic acid ester, alanine, N-acetylglycoprotein, formate, leucine, alanine, ɑ-ketone glutaric acid, citrate,choline content relatively preoperative elevated. Lipids, trimethyl glycine,glutamic acid, salt, glucose, taurine, isoleucine were decreased.T2group vs L2group： Compared to preoperative，the patients ofthyroid papillary carcinoma with whole thyroidectomy, lactic acid,alanine, creatine, benzyl acetate amide, creatinine, glycine, ɑ-ketoneglutaric acid, fumaric acid, formic acid and hippuric acid salt, citric acidsalt, choline content relative preoperative rise; Glucose, lipid, valine,taurine, acetoacetate, isoleucine, phenylalanine were decline. Comparedwith the T1and L1group, the group significant difference. L1group vs L2group：L2group relatively with L1group，the sarcosine,alanine, benzyl acetate amide, phenylalanine, citric acid salt, hippuric acidsalt, choline, trimethyl glycine were increases; Lactic acid, taurine,glucose, leucine, N-acetyl glycoprotein, valine content were decreased.Conclusion：1.There are significant metabolic differences by themetabonomics MNR analysise method in the patients with thyroid papillarycarcinoma between preoperative and postoperative.2.After the Total thyroidectomy,abnormal metabolites ass-ociated with cancer were decline and abnormal metabolic pathways can beterminated or reduce.3. Patients of thyroid papillary carcinoma with total thyroidectomy,abnormal metabolism markers change is more significant.4. Postoperative the TSH suppression therapy may cause the abnormalmetabolism of the body inevitably, abnormal metabolic pathway of totalthyroidectomy is reduced relatively.There are few side-effects in thepatients of total thyroidectomy after TSH suppression therapy.5.Total thyroidectomy is not inferior to unilateral thyroid resectionfor postoperative recovery and endocrine therapy.