Efficacy of GTET in the treatment of papillary thyroid carcinoma and predictive value of serum sIL-2R,VEGF and ES for postoperative recurrence/metastasis
YAO Xufeng
CHEN Liang
YE Jianhong
SHEN Chao
Abstract：Objective To investigate the efficacy of gasless transaxillary endoscopic thyroidectomy(GTET)in the treatment of papillary thyroid carcinoma(PTC)and the predictive value of serum soluble interleukin-2 receptor(sIL-2R),vascular endothelial growth factor(VEGF)and endostatin(ES)in postoperative recurrence/metastasis.Methods A total of 218 patients with PTC admitted to The First Hospital of Jiaxing from January 2020 to October 2021 were included in the study,all of whom received surgical treatment.All of them were followed up until October 2024,with a minimum follow-up period of 3 years.Among them,117 patients treated with GTET were included in the GTET group and 101 patients treated with endoscopic thyroidectomy via areola approach(ETA)were included in the ETA group.During follow-up,there were 31 cases of recurrence/metastasis(including 7 cases of recurrence and 24 cases of metastasis).According to postoperative recurrence/metastasis,the recurrence/metastasis group(n=31)and the non-recurrence/metastasis group(n=187)were included.Perioperative indexes,postoperative recovery,postoperative efficacy and complications 7 d after surgery,and recurrence/metastasis during follow-up were analyzed in the GTET group and the ETA group.Serum sIL-2R,VEGF and ES levels were compared between the recurrence/metastasis group and the non-recurrence/metastasis group.The predictive value of serum sIL-2R,VEGF,and ES levels alone and in combination in PTC patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the ETA group,the operation time,extubation time and postoperative hospitalization days in the GTET group were shorter,and the intraoperative blood loss and the pain score at 3 d after surgery were lower(P＜0.01).The total effective rate of the GTET group was higher than that of the ETA group 7 d after surgery(P＜0.05).During the follow-up period,there was no significant difference in the recurrence/metastasis rate between the two groups(P＞0.05).The incidence of complications in the GTET group was lower than that in the ETA group 7 d after surgery(P＜0.05).The serum sIL-2R,VEGF and ES levels in the recurrence/metastasis group were higher than those in the non-recurrence/metastasis group(P＜0.01).The ROC curve was drawn to analyze the predictive value of serum sIL-2R,VEGF and ES levels alone and in combination for recurrence/metastasis in PTC patients.The areas under the curve(95％CI)were 0.760(0.698-0.815),0.706(0.641-0.766),0.752(0.690-0.808),and 0.898(0.849-0.934),respectively.The combined detection showed the highest predictive performance(Z=2.234,3.355,and 3.335,P＜0.01).Conclusion The efficacy of GTET in the treatment of PTC is superior to that of the ETA group,which can improve perioperative indexes,promote postoperative recovery and reduce the risk of complications,but does not affect the rate of postoperative recurrence/metastasis.The combined detection of serum sIL-2R,VEGF and ES levels has a high value in predicting postoperative recurrence/metastasis.
Keywords：papillary thyroid carcinomagasless transaxillary endoscopic thyroidectomysoluble interleukin-2 receptorvascular endothelial growth factorendostatinrecurrence/metastasispredictive value
Publication Date：2025-07-31
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：6( 917-922 )