Midkine在甲状腺癌标志物中的价值

The value of Midkine as a thyroid cancer marker

  • 摘要: Midkine(MK)有多重生物学功能,对肿瘤的诊治具有重要作用。MK在不同的肿瘤中高度表达,促进癌细胞增殖、迁移和新生血管形成。近年来的研究发现,MK和甲状腺癌关系密切。免疫组化研究表明,MK在甲状腺癌细胞和组织中的表达明显高于正常甲状腺。甲状腺结节穿刺洗脱液的MK水平对甲状腺结节的良恶性判断有很好的诊断价值。MK是可分泌到血液中的细胞因子,其作为血清学标志物可以判断甲状腺结节良恶性,对分化型甲状腺癌131I治疗的预后(是否存在转移病灶)有明确的判断价值。在甲状腺球蛋白抗体阳性的情况下,MK可作为预测分化型甲状腺癌转移的有效血清学标志物。MK的最大局限性是肿瘤特异性差,很多情况下,需要和其他特异性强的肿瘤标志物联合测定。今后的研究重点是MK在甲状腺癌发生、发展和治疗耐药机制方面的探讨。笔者主要综述MK在甲状腺癌标志物中的价值。

     

    Abstract: Midkine (MK) has multiple biological functions, and plays an important role in the diagnosis and treatment of tumor. Midkine is generally overexpressed in diverse malignant tumors, and enhances proliferation, migration and angiogenic activity of tumor cells. Recent studies have found that MK is closely related with thyroid cancer. Immunohistochemical studies showed that MK expression in thyroid cancer cells and tissues was significantly higher than that of normal thyroid. MK level of the needle aspiration eluant had a good diagnostic value for the differentiationbetween benign and malignant thyroid nodules. MK is cytokinesecreted in the blood; it could be used as a serological marker for the differentiation between benign and malignant thyroid nodules. MK could also beapplied for the prognosis of differentiated thyroid carcinoma treated by 131I (whether with or without metastases). In addition, in the case of thyroglobulin antibody positivity, MK could be surrogated as a viable serological marker for predicting thyroid cancer metastasis. The major limitation of MK is lowoncological specificity. In many cases, it is necessary to measure MK with other specific tumor markers. Future researches should focus on the mechanism of MK in the occurrence, development and therapeutic resistance of thyroid cancer. This review discusses the value of MK as a thyroid cancer marker.

     

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