Evaluation of Significant Biomarkers Associated with Progression Free Survival and Overall Survival in Thyroid Cancer Patients Open Access

Lasanajak, Yi (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/gx41mj280?locale=en


Thyroid cancer is the most prevalent endocrine cancer, and its incidence rate has increased over the last few decades. Although survival outcomes following surgery remain favorable, patients still have a lifelong risk of recurrence. The utility of cellular- and serum-based immunologic mediators as potential biomarkers of thyroid cancer recurrence was assessed in this study. Thirty five patients with differentiated thyroid cancer and twenty one healthy controls were enrolled in the study. Absolute counts of lymphocyte cell subsets and levels of immune regulatory cytokines were determined in peripheral blood samples using multiparameter flow cytometry and 51-panel multiplex ELISA (Luminex) assay. Functional activity of circulating B, T and NK lymphocytes was assessed. Differences in mean biomarker levels between recurrence and remission group, or between disease and normal groups were assessed by t-test or Wilcoxon test statistics at the significance level of 0.05. Significant correlations between biomarkers and disease progression were assessed by univariate and multivariate analyses with the COX proportional hazard model. Optimal cut-off values maximizing the sum of sensitivity and specificity of predicting recurrence and disease were established by receiver operating characteristics (ROC) analysis. The overall survival rate for thyroid cancer patients was 91% in this study. Fifteen out of 35 patients (43%) had recurrence. CD4+ T cells, CD8+ T cells, Tregs, and NK cells in the peripheral blood of thyroid cancer patients were higher than in controls. The most significant cytokines correlated with disease recurrence on multivariate analyses were sFAS Ligand (adjusted HR, 0.330; 95% CI (0.136 - 0.799); p = 0.014) and IFN-α (adjusted HR, 4.061; 95% CI (1.453 - 11.347); p = 0.008). These biologically relevant cytokines will be valuable in a risk-adapted surveillance strategy for thyroid cancer.

Table of Contents

Table of Contents

Chapter I Introduction

Chapter II Methods

Chapter III Results

Chapter IV Discussion



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