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      Expression of ANGPTL2 and its impact on papillary thyroid cancer

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          Abstract

          Background

          Although the most thyroid carcinoma patients have good prognosis, around 20% of papillary thyroid carcinoma (PTC) patients have a high rate of metastasis and recurrence after routine treatment, which causes high lethality with these patients. Tumor proliferation, metastasis, and invasion are important predictors of PTC invasiveness and are key factors in cancer-related death. Angiopoietin-like 2 (ANGPTL2), a secreted protein which belongs to the angiopoietin (ANGPTL) family, was reported to be involved in the regulation of several different type of cancer cell proliferation and metastasis. However, whether ANGPTL2 plays a role in the progression of PTC, particularly in metastasis and recurrence of PTC, remains unclear. Hence, the purpose of this study was to evaluate the level of ANGPTL2 in PTC and normal thyroid, as well as para-cancerous tissue. Furthermore, the impact of ANGPTL2 on PTC cell proliferation, metastasis, recurrence and invasion was assessed to investigate the possibility whether ANGPTL2 may become a novel target for PTC therapy and cancer prognosis.

          Materials and methods

          The level of ANGPTL2 in PTC and para-cancerous tissue was assessed by immunohistochemistry. The biological effect of ANGPTL2 on thyroid cancer cell proliferation and metastasis was investigated by the Cell Counting Kit-8 (CCK8) assay, cell scratch test, and transwell assay. Correlations of ANGPTL2 expression levels with proliferation, migration, and metastasis of thyroid cancer were assessed with the TCGA data set and analyzed by gene set enrichment analysis. Receiver operating characteristic analysis was used to evaluate the utility of ANGPTL2 as a biomarker for prediction of thyroid cancer. Survival analysis was performed using the thyroid cancer database in K–M Plotter to detect correlations between survival time and ANGPTL2 levels.

          Results

          Current study revealed that: (1) ANGPTL2 was highly expressed in thyroid cancer in comparison with adjacent normal thyroid tissue; (2) ANGPTL2 expression was increased with thyroid tumor progression; (3) ANGPTL2 increased proliferation of thyroid cancer cells; (4) ANGPTL2 promoted migration and invasion of thyroid cancer cells; (5) high level of ANGPTL2 in thyroid cancer patients were significantly associated with a poor prognosis. The patients showed a higher metastasis and recurrence rate.

          Conclusion

          ANGPTL2 promoted and enhanced proliferation, metastasis, and invasion of thyroid cancer cells. ANGPTL2 may be considered as a potential biomarker for diagnosis and prognosis of thyroid cancer patients. Further evaluation needs to be done to analyze the possibility of taking ANGPTL2 as a prognostic marker and therapeutic target for papillary thyroid cancer.

          Electronic supplementary material

          The online version of this article (10.1186/s12935-019-0908-9) contains supplementary material, which is available to authorized users.

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          Most cited references21

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          Genetic alterations and their relationship in the phosphatidylinositol 3-kinase/Akt pathway in thyroid cancer.

          To investigate the overall occurrence and relationship of genetic alterations in the phosphatidylinositol 3-kinase (PI3K)/Akt pathway in thyroid tumors and explore the scope of this pathway as a therapeutic target for thyroid cancer. We examined collectively the major genetic alterations and their relationship in this pathway, including PIK3CA copy number gain and mutation, Ras mutation, and PTEN mutation, in a large series of primary thyroid tumors. Occurrence of any of these genetic alterations was found in 25 of 81 (31%) benign thyroid adenoma (BTA), 47 of 86 (55%) follicular thyroid cancer (FTC), 21 of 86 (24%) papillary thyroid cancer (PTC), and 29 of 50 (58%) anaplastic thyroid cancer (ATC), with FTC and ATC most frequently harboring these genetic alterations. PIK3CA copy gain was associated with increased PIK3CA protein expression. A mutual exclusivity among these genetic alterations was seen in BTA, FTC, and PTC, suggesting an independent role of each of them through the PI3K/Akt pathway in the tumorigenesis of the differentiated thyroid tumors. However, coexistence of these genetic alterations was increasingly seen with progression from differentiated tumor to undifferentiated ATC. Their coexistence with BRAF mutation was also frequent in PTC and ATC. The data provide strong genetic implication that aberrant activation of PI3K/Akt pathway plays an extensive role in thyroid tumorigenesis, particularly in FTC and ATC, and promotes progression of BTA to FTC and to ATC as the genetic alterations of this pathway accumulate. Progression of PTC to ATC may be facilitated by coexistence of PI3K/Akt pathway-related genetic alterations and BRAF mutation. The PI3K/Akt pathway may thus be a major therapeutic target in thyroid cancers.
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            Changing Trends in the Incidence of Thyroid Cancer in the United States.

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              Differentiated thyroid cancer.

              Differentiated thyroid cancer, which includes papillary and follicular histologies, is a common malignancy and is increasing in incidence. It carries a favorable prognosis compared to other cancers. However, optimal outcomes are achieved only via coordinated multimodal therapy. Of these treatments, surgery is the cornerstone of initial management. Most patients should undergo thyroidectomy with concomitant central neck (level VI) lymph node dissection. On the other hand, thyroidectomy alone may be appropriate for patients with smaller tumors (T1 or T2) and no evidence of suspicious lymphadenopathy. Surgery is also indicated in cases of cervical lymph node metastases and locoregional recurrence. The principal adjuvant therapy is radioactive iodine, which should be considered in patients with a high risk of locoregional recurrence or with metastatic disease. Similarly, suppression of endogenous thyroid-stimulating hormone is recommended in patients with an elevated risk of recurrence. External-beam radiotherapy is indicated in patients with gross extrathyroidal extension or residual disease not amenable to surgery. Finally, molecular therapies, especially those targeting key tyrosine kinases and/or inhibiting angiogenesis, are emerging treatment modalities that could replace the limited efficacy of conventional chemotherapy. Copyright © 2010 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                lingbeiyangstudent@163.com
                sunrongxinsrx@163.com
                wangyanaa123@126.com
                fuyingrlyfe@163.com
                497788519@qq.com
                001jiaoni@163.com
                0086-10-69543901 , lhyyjzl@163.com
                0086-10-69543901 , zdoc66@126.com
                Journal
                Cancer Cell Int
                Cancer Cell Int
                Cancer Cell International
                BioMed Central (London )
                1475-2867
                30 July 2019
                30 July 2019
                2019
                : 19
                : 204
                Affiliations
                [1 ]ISNI 0000 0004 0369 153X, GRID grid.24696.3f, Beijing Key Laboratory of Diabetes Prevention and Research, Department of Endocrinology, Luhe Hospital, , Capital Medical University, ; Beijing, 101149 China
                [2 ]ISNI 0000 0004 0369 153X, GRID grid.24696.3f, Department of General Surgery, Luhe Hospital, , Capital Medical University, ; Beijing, 101149 China
                Author information
                http://orcid.org/0000-0002-9847-5439
                Article
                908
                10.1186/s12935-019-0908-9
                6668118
                31384179
                335c1bc6-fd83-4fb9-b21b-4d9fa7d7e74d
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 27 December 2018
                : 15 July 2019
                Categories
                Primary Research
                Custom metadata
                © The Author(s) 2019

                Oncology & Radiotherapy
                papillary thyroid carcinoma,angiopoietin-like 2,proliferation,metastasis,prognosis

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