VEGF-D and A Preoperative Serum Levels Predict Nodal and Distant Metastases in Differentiated Thyroid Cancer Patients

World J Surg. 2015 Jul;39(7):1742-9. doi: 10.1007/s00268-015-3016-6.


Background: Preoperative tumor aggressiveness biomarkers may help surgeons decide the extent of an operation. However, whether serum angiogenetic factors can be used to predict the prognosis of patients with differentiated thyroid cancer is still unclear.

Methods: Seventy-six DTC patients were prospectively recruited. Preoperative serum samples were collected and measured for Tie-2, Ang-1, Ang-2, VEGF-A, and VEGF-D levels. The potential correlations between their serum levels and clinicopathologic features as well as their prognoses were analyzed.

Results: Older age (>45 years old) and higher VEGF-A serum levels were independent predictors of extrathyroidal extension. The VEGF-D serum level was an independent factor for lymph node metastases and VEGF-A was an independent factor for distant metastases. None of these serum angiogenetic factors were significantly different between patients who were disease free and those with recurrences. The presence of lymph node metastases was the only independent factor for recurrence over the 2-year follow-up.

Conclusion: Preoperative serum VEGF-A and VEGF-D levels were significantly elevated in DTC patients with distant and lymph node metastases. These findings, when combined with other clinicopathological factors, may help in surgical decisions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Follicular / blood
  • Adenocarcinoma, Follicular / pathology*
  • Adenocarcinoma, Follicular / surgery
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Angiopoietins / blood
  • Biomarkers, Tumor / blood*
  • Carcinoma, Papillary / blood
  • Carcinoma, Papillary / pathology*
  • Carcinoma, Papillary / surgery
  • Child
  • Female
  • Humans
  • Lymph Nodes / pathology
  • Lymphatic Metastasis*
  • Male
  • Middle Aged
  • Neoplasm Metastasis*
  • Neoplasm Recurrence, Local / pathology
  • Prognosis
  • Prospective Studies
  • Receptors, TIE / blood
  • Thyroid Neoplasms / blood
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / surgery
  • Vascular Endothelial Growth Factor A / blood*
  • Vascular Endothelial Growth Factor D / blood*
  • Young Adult


  • Angiopoietins
  • Biomarkers, Tumor
  • VEGFA protein, human
  • VEGFD protein, human
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factor D
  • Receptors, TIE