Premium
Midkine concentrations in fine‐needle aspiration of benign and malignant thyroid nodules
Author(s) -
Jee Youn Hee,
Celi Francesco S.,
Sampson Maureen,
Sacks David B.,
Remaley Alan T.,
Kebebew Electron,
Baron Jeffrey
Publication year - 2015
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12676
Subject(s) - thyroid nodules , midkine , medicine , thyroid , thyroglobulin , thyroidectomy , fine needle aspiration , thyroid cancer , pathology , radiology , nuclear medicine , biopsy , growth factor , receptor
Summary Context The primary preoperative method for distinguishing malignant from benign thyroid nodules is fine‐needle aspiration ( FNA ) cytology, but it is frequently inconclusive. Midkine ( MDK ) is a heparin‐binding growth factor, which is overexpressed in papillary thyroid carcinoma ( PTC ). Objective We measured MDK concentrations in FNA samples from benign and malignant thyroid nodules to explore the possibility that MDK measurement might aid in the evaluation of thyroid nodules. Design 35 subjects underwent preoperative FNA of 45 thyroid nodules, followed by thyroidectomy, providing a histological diagnosis. FNA needle contents were first expressed for cytology, and then, the needle was washed with buffer for immunoassay. In 46 subjects without preoperative FNA samples, FNA was performed ex vivo on 62 nodules within surgically excised thyroid tissue. Measurements MDK was measured using a high‐sensitivity sandwich ELISA and normalized to thyroglobulin (Tg) concentration in the sample to adjust for tissue content in the aspirate. Results The MDK /Tg ratio was higher in 18 PTC s than in 87 benign nodules (204 ± 106 vs 1·2 ± 0·3 ng/mg, mean ± SEM , P < 0·001). Using a threshold of 10 ng/mg, the sensitivity and specificity of the MDK /Tg ratio for diagnosis of PTC were 67% and 99%, respectively. All follicular variant PTC s had a MDK /Tg ratio <10 ng/mg. Conclusions The findings indicate that, in FNA samples, the MDK /Tg ratio in PTC is greater than in benign thyroid nodules, raising the possibility that this approach might provide adjunctive diagnostic or prognostic information to complement existing approaches.