To investigate the relationship between the expression levels of chemokines in serum of patients with differentiated thyroid carcinoma (DTC) and the progression of DTC.

From January to April in 2017, blood samples of 76 patients (25 males, 51 females, median age: 39 years) with DTC after surgery in Nuclear Medicine Department of Tenth People′s Hospital Affiliated to Tongji University were collected retrospectively for detecting the expression levels of 40 chemokines. Patients were divided into different groups according to (1) with or without metastasis: the non-metastasis group (n=13) and the metastasis group (n=63); (2) degree of gradual dedifferentiation: without metastasis group (n=13), lymph node metastasis group (n=48), highly malignant group (n=11) and radioactive iodine refractory (RAIR) with distant metastasis group (n=4); (3) frequency of ¹³¹I treatment in follow-up for nearly 2 years: single treatment group (n=51) and multiple treatment group (n=25). Differences in chemokine levels among groups were compared. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of differential chemokines′ levels on DTC metastasis and multiple ¹³¹I treatment. Independent-sample t test, Mann-Whitney U test and one-way analysis of variance were used to analyze the data.

Compared with the non-metastatic group, the expression levels of Eotaxin-3 ((25.94±6.05) vs (21.76±5.71) ng/L), interferon-γ (IFN-γ; (116.04±28.98)vs (98.71±26.18) ng/L), macrophage-derived chemokine (MDC; (1 468.08±401.74) vs (1 082.94±423.30) ng/L) and thymus expressd chemokine (TECK; (505.22(419.80, 563.36) vs 402.89(347.43, 442.97) ng/L) in metastatic group were decreased, and the differences were statistically significant (t values: 2.376, 2.131, 3.007, U=215.000, all P<0.05). The area under the ROC curve of IFN-γ+ MDC+ TECK for predicting DTC metastasis was 0.844(95%CI: 0.755-0.932, P<0.001), and the sensitivity was 79.37%(50/63). Only the differences of MDC among without metastasis group, lymph node metastasis group, highly malignant group and RAIR with distant metastasis group were significant ((1 468.08±401.74), (1 121.59±454.20), (976.07±281.04), (922.68±342.41) ng/L;F=3.564, P<0.05), and the expression was gradually decreased with the degree of dedifferentiation. Only IL-8 was significantly increased in the multiple treatment group compared with the single treatment group (28.20(23.22, 32.51)vs 30.51(26.98, 35.57) ng/L; U=801.000, P<0.05). The area under the ROC curve of IL-8 for predicting multiple¹³¹I treatment was 0.648(95% CI: 0.523-0.773, P<0.05), and the sensitivity was 100%(25/25).

Decreased expression of IFN-γ, MDC and TECK may be potential markers for predicting metastasis in DTC. MDC is likely to be a potential molecular target for detecting the dedifferentiation degree of DTC, decreased expression of which may indicate the increased malignancy of tumor. IL-8 may be used to predict whether patients need multiple¹³¹I treatments.

Thyroid neoplasms; Chemotactic factors; Neoplasm metastasis; Radiotheraphy; Iodine radioisotopes; Forecasting