Change of Serum Antithyroglobulin Antibody Levels Is Useful for Prediction of Clinical Recurrence in Thyroglobulin-Negative Patients with Differentiated Thyroid Carcinoma

Kim, Won Gu; Yoon, Jong Ho; Kim, Tae Yong; Kim, Eui Young; Kim, Jung Min; Ryu, Jin-Sook; Gong, Gyungyub; Hong, Suck Joon; Shong, Young Kee

doi:10.1210/jc.2008-0962

Cited by 196 publications

(180 citation statements)

References 20 publications

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“…Although undetectable pre-ablation Tg levels usually indicate complete previous surgery, our data reinforce earlier observations that, in a low percentage of patients, this situation may be related to non-detectable Tg or to the presence of TgAb (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)31). We believe that, when concurrent chronic thyroiditis is found by the pathologist, or when initial TNM stages are diswith DTC, compared with the 10% generally seen in the general population (20).…”

Section: Discussionsupporting

confidence: 89%

“…found that less than 1% of patients who became TgAb-negative or displayed more than 50% decrease in TgAb levels over the 6 to 12 months period after radioiodine treatment had recurrence detected during follow-up. In contrast, 19% of patients in whom TgAb decreased less than 50%, as well as the 37% in whom TgAb concentrations rose, were diagnosed with recurrence (29).…”

Section: Discussionmentioning

confidence: 93%

“…Patients may not achieve negative TgAb status during the first postoperative year, and may even exhibit a rise (or de novo appearance of TgAb during the 6 months after a radioiodine treatment, when there is release of Tg antigen secondary to lytic cell damage of thyroid tissue) (27,28). Clearly, it is the long-term trend in TgAb concentrations that is more valuable than any single TgAb level per se (29). Kim and cols.…”

Section: Discussionmentioning

confidence: 99%

“…Up to 20% of patients may present Tg-Antibodies (TgAb), which might obscure the evidence of detectable Tg (3,4). TgAb are also considered as surrogate markers for the persistence of disease (1,2,(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

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Undetectable pre-ablation thyroglobulin levels in patients with differentiated thyroid cancer: it is not always what it seems

Pitoia

Bueno

Abelleira

et al. 2013

Arq Bras Endocrinol Metab

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Objective: To establish the frequency of U Tg (undetectable pre-ablation thyroglobulin) in TgAbnegative patients and to evaluate the outcome in the follow-up. Subjects and methods: We retrospectively reviewed 335 patients' records. Twenty eight patients (9%) had U Tg. Mean follow--up was 42 ± 38 months. All subjects had undergone total thyroidectomy, and lymph nodes were positive in 13 (46%) patients. Tg and TgAb levels were measured 4 weeks after surgery by IMA technology in hypothyroid state. No evidence of disease (NED) status was defined as undetectable (< 1 ng/mL) stimulated Tg and negative Tg-Ab and/or negative WBS, together with normal imaging studies. Results: Seventeen patients (61%) were considered with NED. Four patients (14%) had persistent disease (mediastinum, n = 1, lung n = 2, unknown n = 1), and 7 (25%) had detectable TgAb by other method during their follow-up. Conclusions: U Tg levels usually is associated to a complete surgery. However, in a low percentage of patients, this may be related to false negative Tg or TgAb measurement. Arq Bras Endocrinol Metab. 2013;57(4):300-6 Keywords Undetectable thyroglobulin levels; thyroglobulin; ablation; thyroid; cancer RESUMO Objetivo: Estabelecer a frequência de U Tg (tireoglobulina indetectável pré-ablação) em pacientes com TgAb negativo e avaliar o prognóstico no seguimento. Sujeitos e métodos: Foram analisados retrospectivamente 335 registros de pacientes. Vinte e oito pacientes (9%) tiveram U Tg. O acompanhamento médio foi de 42 ± 38 meses. Todos os participantes receberam uma tireoidectomia total, e os linfonodos foram positivos em 13 (46%) pacientes. Tg e TgAb foram medidos quatro semanas após a cirurgia pelo método IMA em estado de hipotireoidismo. A não evidência de doença (NED) foi definida como níveis indetectáveis (<1 ng/mL) de Tg estimulada com anticorpos anti-Tg negativos e/ou PCI negativo, com estudos de imagem normais. Resultados: Dezessete pacientes (61%) foram considerados com NED. Quatro pacientes (14%) tiveram doença persistente (mediastino, n = 1, pulmão n = 2, n = desconhecido 1), e 7 (25%) apresentavam anticorpos anti-Tg detectáveis por outro método durante acompanhamento. Conclusões: U Tg geralmente indica uma cirurgia completa. No entanto, em uma pequena porcentagem de pacientes, pode estar relacionada com uma medida de Tg ou de anticorpos anti--Tg falsamente negativos. Arq Bras Endocrinol Metab. 2013;57(4):300-6

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Undetectable pre-ablation thyroglobulin levels in patients with differentiated thyroid cancer: it is not always what it seems

Pitoia

Bueno

Abelleira

et al. 2013

Arq Bras Endocrinol Metab

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“…The trend of anti-TgAb levels over time (9)(10)(11)(12) and serial imaging based on the extent of disease (13,14) are generally recommended for monitoring these patients. Measurement of Tg-LC/MS has been developed as a method to provide an accurate level of Tg, avoiding the interference of these antibodies, and over the past few years, it has been adopted by several commercial laboratories.…”

Section: Discussionmentioning

confidence: 99%

Thyroglobulin Liquid Chromatography–Tandem Mass Spectrometry Has a Low Sensitivity for Detecting Structural Disease in Patients with Antithyroglobulin Antibodies

Azmat

Porter

Senter

et al. 2017

Thyroid

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Background: Thyroglobulin (Tg) measurement in patients with positive antithyroglobulin antibodies (antiTgAbs) is not reliable. Tg measurement using liquid chromatography-tandem mass spectrometry (LC/MS) may be useful in this setting. Methods: This is a retrospective study with the objective of determining the accuracy of Tg-LC/MS in patients with thyroid cancer with anti-TgAbs. All patients with follicular cell-derived thyroid cancer (TC) who had thyroglobulin measured using LC/MS assay from November 1, 2013, to November 7, 2014, were evaluated. The frequency of detectable Tg-LC/MS was evaluated, with a functional sensitivity (FS) of 0.5 ng/mL in patients with structural disease. Then performance of Tg-LC/MS versus Tg immunometric assay (IMA) was compared using either Immulite assay (Tg-1) with a FS of 0.9 ng/mL or Beckman assay (Tg-B) with a FS of 0.1 ng/mL in detecting structural disease in patients with positive anti-TgAbs. Results: A total of 154 consecutive patients were included in this evaluation. Of these, 116 (75%) patients were positive for anti-TgAbs. In patients with structural disease and positive anti-TgAbs, Tg-LC/MS was undetectable in 43.7% of patients. Then the diagnostic accuracy for structural disease of Tg-LC/MS was compared with each Tg-IMA assay separately. In the 26 patients with positive anti-TgAbs where a Tg-I assay was used, the sensitivity and specificity for detecting structural disease were 33.3% and 88.2%, respectively, for the Tg-I assay, and 44.4% and 94.1%, respectively, for the Tg-LC/MS assay. In the 74 patients with positive anti-TgAbs where Tg-B was used, the sensitivity and specificity for detection of structural disease were 72.7% and 71.4%, respectively, for the Tg-B assay, and 62.6% and 93.7%, respectively, for the Tg-LC/MS assay. Conclusion: In patients with thyroid cancer with positive anti-TgAbs, Tg-LC/MS was frequently undetectable and was less sensitive for detecting disease than a Tg assay was with a functional sensitivity of 0.1 ng/mL. For patients with detectable Tg-LC/MS and anti-TgAbs, use of the assay for monitoring requires further prospective studies.

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The value of preoperative antithyroidperoxidase antibody as a novel predictor of recurrence in papillary thyroid carcinoma

Song

Jeon

et al. 2018

Intl Journal of Cancer

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The link between chronic lymphocytic thyroiditis (CLT) and papillary thyroid carcinoma (PTC) is widely recognized. Considering the strong association between raised antithyroidperoxidase antibody (TPOAb) and CLT, we postulated that the preoperative TPOAb can predict the prognosis of PTC, particularly for recurrence. A total of 2,070 patients who underwent total thyroidectomy for classical type PTC with tumor size 1 cm and with available data on preoperative TPOAb and TgAb were enrolled to compare disease-free survival (DFS) according to the presence of preoperative TPOAb, TgAb, and coexistent CLT. Patients with positive preoperative TPOAb had a significantly better DFS compared to patients without positive preoperative TPOAb (hazard ratio (HR) 0.53; 95% confidence interval (CI) 0.30-0.94, p = 0.028) while no difference in DFS was found according to preoperative TgAb status. Positive preoperative TPOAb was an independent prognostic factor for structural persistent/recurrent disease after adjustment for major preoperative risk factors such as age, sex, and tumor size (HR 0.52, 95% CI 0.28-0.99, p = 0.048). Although the coexistence of CLT lowered the risk for structural persistence/recurrence in univariate analysis (HR 0.52, 95% CI 0.31-0.86, p = 0.012), it was not an independent favorable prognostic factor by multivariate analysis (HR 0.65, 95% CI 0.38-1.10, p = 0.106). However, when coexistent CLT was combined with positive preoperative TPOAb, it indicated an independent protective role in structural persistent/recurrent disease (HR 0.39, 95% CI 0.16-0.98, p = 0.045). Our study clearly showed that presence of preoperative TPOAb can be a novel prognostic factor in predicting structural persistence/recurrence of PTC.

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Change of Serum Antithyroglobulin Antibody Levels Is Useful for Prediction of Clinical Recurrence in Thyroglobulin-Negative Patients with Differentiated Thyroid Carcinoma

Cited by 196 publications

References 20 publications

Undetectable pre-ablation thyroglobulin levels in patients with differentiated thyroid cancer: it is not always what it seems

Undetectable pre-ablation thyroglobulin levels in patients with differentiated thyroid cancer: it is not always what it seems

Thyroglobulin Liquid Chromatography–Tandem Mass Spectrometry Has a Low Sensitivity for Detecting Structural Disease in Patients with Antithyroglobulin Antibodies

The value of preoperative antithyroidperoxidase antibody as a novel predictor of recurrence in papillary thyroid carcinoma

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