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ORIGINAL ARTICLE
Year : 2019  |  Volume : 16  |  Issue : 3  |  Page : 95-99

Assessment of serum midkine level in benign and malignant thyroid nodules. Can midkine be a marker of thyroid malignancy?


1 Department of Internal Medicine and Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Department of Internal Medicine, National Institute of Diabetes and Endocrinology, Cairo, Egypt

Correspondence Address:
Dr. Rana Hashem Ibrahim Elattary
New Cairo, 1st Setellment, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/trp.trp_38_19

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Background: Thyroid nodules are a common clinical problem. The prevalence of malignancy in thyroid nodules is currently about 5%–15%. Fine-needle aspiration biopsy (FNAB) has improved the preoperative prediction of malignancy, but still has disadvantages including operator variability and nondiagnostic reports. Midkine (MK) is a novel heparin-binding growth factor; MK levels have been proposed as indicative of malignancy in numerous tumors. MK overexpression in thyroid cancer has been reported to be in correlation with clinicopathological features of the tumor, hypothesizing that MK might play a role as a biomarker for diagnosis and more aggressive behavior of thyroid cancer. Aim: The aim of this study is to evaluate the value of serum MK (SMK) as a marker of malignancy in patients with nodular thyroid disease. Patients and Methods: The current study included 75 individuals with age ranging from 25 to 80 years divided into 25 with malignant thyroid nodule (Group A), 25 with benign thyroid nodule (Group B), and 25 healthy individuals as a control group (Group C). Free triiodothyronine, free thyroxin, thyroid-stimulating hormone, and SMK levels were assessed. Individuals with thyroid nodules were submitted for neck ultrasonography and FNAB. Results: On comparing the three studied groups, a high statistically significant difference in plasma MK levels was found (P < 0.001), being higher in Group A (malignant nodule) with a mean of 1.127 ± 0.527 than Group B (benign nodule) with a mean of 0.536 ± 0.301 with P < 0.001* and also higher in Group A (malignant nodule) with a mean of 1.127 ± 0.527 than Group C (control) with a mean of 0.366 ± 0.230 with P < 0.001*. There was significant difference regarding MK levels, with thyroid nodule contour being higher in thyroid nodule with irregular contour than thyroid nodule with regular contour (P < 0.001*) and calcification being higher in microcalcification than macrocalcification (P = 0.006*). There was high statistically significant difference regarding the level of MK between papillary carcinoma and follicular carcinoma (P < 0.001*). Conclusions: SMK might be the indicator of malignant thyroid cytopathology, suggesting that MK might serve as a novel biomarker in the assessment of thyroid nodules. The present study explored the usefulness of MK as a biomarker in the differentiation between benign and malignant thyroid nodules in samples from serum.


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