ENDO 2013: The Endocrine Society 95th Annual Meeting & Expo:

Midkine Concentration in the Diagnosis of Papillary Thyroid Cancer

Research about papillary thyroid cancer (PTC) was presented at The Endocrine Society's 95th Annual Meeting (ENDO 2013) by Youn Hee Jee, MD. Dr. Jee is a postdoctoral fellow at the National Institute of Child Health and Human Development (NICHD) and National Institutes of Health (NIH) in Bethesda, MD. Dr. Jee and her colleagues hypothesized midkine (heparin binding growth factor [MK]) concentration in PTC may be higher than in benign neoplasms. Furthermore, MK measurement in fine-needle aspiration (FNA) samples may aid in the pre-operative diagnosis of thyroid nodules.

Currently, diagnosis usually includes thyroid ultrasound and FNA of neoplasms larger than 1.0 cm. Unfortunately, FNA cytology results are often non-diagnostic and surgery is required to confirm malignancy. Considering that approximately 80% of all thyroid cancers are PTC, Dr. Jee's research is interesting.

44 patients participated in the study

  • 24 had pre-operative FNA and then underwent thyroidectomy. The FNA contents were expressed for cytology and thereafter the needle was washed with buffer for immunoassay.
  • 20 participants underwent thyroidectomy (without pre-operative FNA). FNA was performed on surgically excised tissue.
  • MK concentrations were measured using a high-sensitivity sandwich ELISA.
  • Thyroglobulin (Tg) was measured using a chemiluminescent immunoassay (CLIA).

 Study Results

  • MK was higher in 11 PTCs
  • MK was lower in 40 benign nodules
  • MK was normalized to Tg to enhance differences between the benign and malignant samples
  • The MK/Tg ratio in PTC was greater than in the benign nodules
  • The MK/Tg ratio for PTC was 64% and 100%, respectively 
  • The area beneath the Receiver Operating Characteristic (ROC) curve was 0.84 
  • Plasma MK concentrations were similar between participants with PTC and benign nodules


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