Patterns of Angiogenic Factors (VEGF, Angiopoietin-1) in Patients with Benign Thyroid Lesions Before and After Surgery

Abstract

Background: Angiogenesis plays an important role in goiter development with endothelial cell proliferation occurring before increased proliferation of the thyroid follicular cells and increase in both vascular endothelial growth factor (VEGF) and Angiopoietin-1 (Ang-1) in the serum and intrathyroid tissue. Objective: The aim of the current work was to measure the levels of VEGF and Ang-1 in patients with benign thyroid disorders before and after thyroidectomy and compare it to the normal control subjects. Patients and Methods: This prospective study included a total of 80 patients provisionally diagnosed as benign thyroid disorders and 50 apparently healthy subjects served as a control group, attending at Outpatient Clinics of Endocrine Surgery Unit, Mansoura University Hospital. This study was conducted between February 2017 to February 2020. Of the 80 patients, 12 (15%) were male and 68 (85%) were female and their age ranged from 19 to 60 years (median = 40.41 years). On admission, careful history taking, clinical examinations and different investigations were done. Results: Thirty patients had benign multinodular goiter, 20 had solitary follicular adenoma, 10 had diffuse toxic, 10 had nodular toxic goiter, and 10 had Hashimoto thyroiditis. In all patients, pre-operative circulating VEGF and Ang1 levels were increased compared to controls (P<0.001), and a decrease after thyroidectomy was observed in the levels of VEGF (P<0.001) in all of them. This decrease was significant after total thyroidectomy compared to near total and hemi-thyroidectomy. Circulating Ang-1 were significantly increased (P<0.001) after thyroidectomy in all patients. Conclusion: It could be concluded that this study raise the potential for VEGF and Ang-1 factor to be used as biomarkers of the effectiveness of thyroidectomy in benign thyroid lesions. These results needs further investigations and may have potential prognostic implications.