南方医科大学学报

南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (12): 1814-.

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血清VEGF-C、VEGF-D及VEGFR-3联合TSH检测在甲状腺乳头状癌诊断中的价值

黄静，李燕萍，薛刚，张文静，李少英，张静，吴靖芳   

  • 出版日期:2014-12-20 发布日期:2014-12-20

Value of VEGF-C, VEGF-D and VEGFR-3 levels combined with serum TSH in diagnosis
of papillary thyroid carcinoma

  • Online:2014-12-20 Published:2014-12-20

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摘要： 目的探讨甲状腺乳头状癌患者血清VEGF-C、VEGF-D和VEGFR-3的表达水平，分析3个指标与临床病理和甲状腺功能
的关系。方法收集就诊于河北北方学院附属第一医院的甲状腺疾病患者的血清及甲功资料。其中甲状腺乳头状癌（PTC）55
例，甲状腺良性肿瘤（BT）24例。采用酶联免疫吸附法检测血清VEGF-C/D和VEGFR-3浓度，并分析每位患者上述3个指标与
甲状腺功能的关系。结果PTC组血清VEGF-C和VEGFR-3浓度明显高于BT组（P<0.05）；VEGF-D浓度在两组间差异无统计
学意义（P>0.05）。PTC患者血清VEGF-C和VEGFR-3浓度在临床Ⅲ/Ⅳ期高于Ⅰ/Ⅱ期、TSH升高组明显高于TSH正常组、年龄
>45岁者明显高于≤45岁者、肿瘤直径>2 cm的患者明显高于≤2 cm的患者（P<0.05或P<0.01），VEGF-C和VEGFR-3在有无淋
巴结转移组变化不一致，淋巴结转移组VEGF-C浓度明显高于无转移组，而VEGFR-3则低于无转移组；二者均与性别无关；血
清VEGF-D浓度在PTC伴淋巴结转移组明显高于无转移组、TSH升高组明显高于正常组（P<0.05或P<0.01），与临床分期、肿瘤
直径以及年龄、性别均无关。血清VEGF-C、VEGFR-3 和TSH 浓度的ROC曲线及线下面积分别为0.803,0.734 和0.707（P<
0.01）；VEGF-D浓度线下面积0.556（P>0.05）。联合VEGF-C、VEGFR-3和TSH三个指标线下面积0.862（P<0.01）。结论联合
检测血清VEGF-C和VEGFR-3的表达水平并结合患者的TSH结果，可以提高甲状腺乳头状癌的早期诊断率。

Abstract: Objective To investigate serum vascular endothelial growth factor-C (VEGF-C), VEGF-D and VEGFR-3 levels in
patients with papillary thyroid carcinoma (PTC) and analyze their relation with the clinicopathological and thyroid function of
the patients. Methods Serum samples and the data of thyroid function were collected from 55 patients with PTC and 24 with
benign thyroid tumor (BT). ELISA was used to detect VEGF-C/D and VEGFR-3 concentration in the serum samples and their
relation with the thyroid function was analyzed. Results The VEGF-C and VEGFR-3 levels were significantly higher in PTC
group than in BT group (P<0.05), but VEGF-D level was comparable between them (P>0.05). In PTC patients, the elevation of
serum VEGF-C and VEGFR-3 levels was associated with an advanced clinical stage (III-IV), elevated thyroid-stimulating
hormone (TSH) level, an age over 45 years, and a tumor diameter exceeding 2 cm (P<0.05 or P<0.01). Patients with lymph node
metastasis had significantly higher VEGF-C level but lower VEGF-3 level than those without metastasis without a gender
dependence. Serum VEGF-D level was higher in PTC patients with lymph node metastasis (P<0.05) and elevated TSH level (P<
0.01) without association with the clinical stage, tumor diameter, age, or gender. The area under Roc Curve (AUC) of serum
VEGF-C, VEGFR-3 and TSH was 0.803, 0.734 and 0.707 respectively (P<0.01), and that of VEGF-D was 0.556 (P>0.05); when
combined, serum VEGF-C, VEGFR-3 and TSH showed an AUC of 0.862 (P<0.01). Conclusion Detecting serum VEGF-C and
VEGFR-3 levels combined with TSH may enhance the early diagnosis rate of papillary thyroid carcinoma.