Relation of postoperative pathologic diagnosis and vascular endothelial growth factor receptor (VEGFR) levels with preoperative fine needle aspiration biopsy (FNAB) and serum vascular endothelial growth factor (VEGF) in patients undergoing thyroidectomy

Thyroid nodules are diagnosed in2% of males and 10% of females by physical examination. Several molecules have been identified in the pathophysiology of thyroid neoplasms. In particular, HGF, PDGF, EGF, TGF α, IGF II, FGF, TSH, estrogen, HCG, GH, VIP and VEGF are associated with aggressivity and metastasis of neoplasms. Vascular endothelial growth factor receptors (VEGFR) are primarily found in endothelial cells and have 3 types of expression. VEGFR-2 is one of the most important mediators of angiogenesis, activated by VEGF as a primer. In our study, we investigated serum VEGF levels and intra-nodal tissue VEGFR-2 levels of patients, compared with thyroid fine needle aspiration biopsy and final pathology whether there was a significant relationship between them. Age, gender, FNAB results, pathologic diagnosis, serum VEGF and tissue VEGFR-2 levels were compared in 75 patients whose operation decision was taken in the endocrine surgical council due to nodular goiter, were performed FNAB and operated by a single surgeon. When compared serum VEGF levels and tissue VEGFR-2 levels with FNAB results, there was no statistically significant difference in serum VEGF levels, whereas tissue VEGFR-2 levels were statistically significant (p= 0.045). It was seen that this difference was caused by group of the suspicious for malignancy. There was a statistically significant difference between histopathological diagnosis and serum VEGF levels and tissue VEGFR-2 groups (p= 0.011). When serum VEGF levels were compared with histopathologic findings, there was a statistically significant difference between papillary thyroid carcinoma and nodular hyperplasia and thyroiditis, but no statistical difference was observed in relation to follicular adenoma. The difference between the serum VEGF and tissue VEGFR2 groups was statistically significant (p: 0.001) this difference was found to be in the group in which the tissue VEGFR2 was overexpressed by more than 60% and it was provided by papillary thyroid carcinoma. In conclusion; when comparing the results of FNAB with tissue VEGFR2 levels, VEGFR2 levels in pathological nodules of patients who were reported to be suspicious for malignancy were found to be significantly higher than the other groups; compared with the histopathological diagnosis, both serum VEGF levels and tissue VEGFR2 levels were found to be significantly higher in patients with papillary thyroid carcinoma. And the increase in VEGF levels in the group which has more than 60% receptor expression showed that there was a significant relationship between tissue VEGFR2 levels and serum VEGF levels.