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[Molecular biological markers for proliferation, apoptosis, and angiogenesis in diffuse toxic goiter]
S V Dora1, M G Rybakova1, D A Alekseev1
1Acad. I.P. Pavlov Saint Petersburg State Medical University, Ministry of Health of the Russian Federation, Saint Petersburg, Russia.
Abstract:
The pathogenesis of diffuse toxic goiter has not yet been fully understood. The literature increasing commonly focusses on the issues related to the processes occurring in the thyroid gland itself: proliferation, apoptosis, and angiogenesis.
Aim:
to investigate clinical and laboratory parameters, as well as the expression of Ki-67, Bcl-2, Bax, Fas-L, CD34, VEGF, and FGF proteins in various postoperative outcomes of patients operated on for diffuse toxic goiter.
Subjects And Methods:
The investigation enrolled 24 women who had undergone surgery using the technique described by E.S. Drachinskaya. Immunohistochemical tests were carried out according to the standard protocol. The expression of Ki-67, Bcl-2, Bax, Fas-L, CD 34, VEGF, angiopoietin, and FGF proteins was determined.
Results:
The patients with postoperative thyrotoxicosis were ascertained to have a significantly greater expression of anti-apoptotic protein Bcl-2, proliferation marker Ki-67, vascular factors (FGF, VEGF), and CD 34.
Conclusion:
The relative expression area of the anti-apoptotic protein Bcl-2 of more than 2.19 or the proliferation protein Ki-67 of more than 1.059 was found to predict the development of postoperative thyrotoxicosis with an accuracy of higher than 85%.
Insights
Elevated levels of anti-apoptotic protein Bcl-2 and proliferation marker Ki-67 in patients with diffuse toxic goiter can predict postoperative thyrotoxicosis with over 85% accuracy. This finding aids in understanding disease recurrence and management.
Area of Science:
- Endocrinology
- Molecular Biology
- Surgical Pathology
Background:
- The exact pathogenesis of diffuse toxic goiter (DTG) remains unclear.
- Research increasingly focuses on thyroid gland processes like proliferation, apoptosis, and angiogenesis in DTG.
- Understanding these cellular mechanisms is crucial for managing postoperative outcomes.
Purpose of the Study:
- To investigate clinical and laboratory parameters in patients undergoing surgery for DTG.
- To evaluate the expression of key proteins (Ki-67, Bcl-2, Bax, Fas-L, CD34, VEGF, FGF) related to cell proliferation, apoptosis, and angiogenesis.
- To correlate protein expression with various postoperative outcomes in DTG patients.
Main Methods:
- The study included 24 women who underwent surgery for DTG.
- Immunohistochemical analysis was performed using standard protocols.
- Expression levels of Ki-67, Bcl-2, Bax, Fas-L, CD34, VEGF, angiopoietin, and FGF proteins were quantified.
Main Results:
- Patients experiencing postoperative thyrotoxicosis showed significantly higher expression of Bcl-2 (anti-apoptotic), Ki-67 (proliferation marker), CD34, and vascular factors (FGF, VEGF).
- These markers are implicated in the cellular changes observed in recurrent or persistent hyperthyroidism post-surgery.
Conclusions:
- Specific thresholds for Bcl-2 ( > 2.19) and Ki-67 ( > 1.059) expression predict postoperative thyrotoxicosis.
- These predictive markers offer a potential tool for assessing recurrence risk and guiding patient management after DTG surgery.
- The findings highlight the role of cellular proliferation and apoptosis in the development of postoperative thyrotoxicosis.
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