For evaluating the clinical significance of thyroglobulin measurements for the follow-up of patients with differentiated thyroid carcinoma, thyroglobulin was determined radioimmunologically during the past 2 years (up to 12 times) in 40 patients after withdrawal of thyroid hormone. Thyroglobulin values were compared with whole-body scintigrams after radioiodine. Thyroglobulin antibodies, which may interfere in the radioimmunoassay for thyroglobulin, were also estimated by a radioimmunologic method. In the majority of cases, thyroglobulin levels corresponded to the scintigrams, however, the thyroglobulin level appeared to be a more precise index for changes in tumor tissue mass. In one patient the scintigram was negative, whereas considerable amounts of thyroglobulin were measured in the serum: X-ray tomography revealed a lung metastase in this case. On the other hand, thyroglobulin was undetectable in the sera of patients who exhibited distinct metastases in the scintigram. Thyroglobulin can be regarded as a tumor marker in patients thyroidectomized for differentiated thyroid carcinoma. However, its determination can certainly not replace whole-body scintigraphy as postulated by several authors, although thyroglobulin measurement appears to be superior to scanning in some cases. A combined application of iodine scanning and thyroglobulin radioimmunoassay is thus advisable in the follow-up of patients with differentiated thyroid carcinoma.
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