Comparison of Seven Serum Thyroglobulin Assays in the Follow-Up of Papillary and Follicular Thyroid Cancer Patients

Schlumberger, Martin; Hitzel, Anne; Toubert, Marie‐Elisabeth; Corone, C.; Troalen, Frédéric; Schlageter, M. H.; Claustrat, Francine; Koscielny, Serge; Taïeb, David; Toubeau, Michel; Bonichon, F.; Borson‐Chazot, Françoise; Leenhardt, Laurence; Schvartz, Claire; Dejax, C.; Brenot-Rossi, I.; Torlontano, Massimo; Tenenbaum, Florence; Bardet, Stéphane; Bussière, Françoise; Girard, J.; Morel, Olivier; Schneegans, Olivier; Schlienger, Jean-Louis; Prost, A.; So, D.; Archambeaud, F.; Ricard, M.; Benhamou, E

doi:10.1210/jc.2006-0723

Cited by 174 publications

(126 citation statements)

References 27 publications

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“…Six months following thyroid ablation, an increase in serum onT4-Tg occurred in four and three patients with (ns4) and without (ns191) proven DTC recurrence, respectively (sensitivity 100%, specificity 98%, positive predictive value 98%, negative predictive value 100%, accuracy 98%). Our data agree with those of Schlumberger and co-workers who showed that Tg immunoassays, with a functional sensitivity of 0.2-0.3 ng/mL (comprising the assay employed in our study), are accurate enough to rule out TSH stimulation in the first followup visit of 944 patients with DTC (13). Here, we also show that false positive results were always associated with a spontaneous decrease within 3-6 months, proving that a negative Tg trend has 100% negative predictive value.…”

Section: Discussionsupporting

confidence: 93%

Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma

Giovanella¹,

Maffioli

Ceriani

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: Thyroglobulin (Tg) measurement following thyrotropin (TSH) stimulation is used in the follow-up of patients with differentiated thyroid carcinoma (DTC). However, high-sensitive assays allow accurate measurement of serum Tg even without TSH stimulation. Here, we prospectively evaluated the impact of unstimulated high-sensitive Tg measurement in early and long-term outcome of patients with DTC. Methods: One hundred and ninety five patients affected with DTC were evaluated. Six months after thyroid ablation (i.e., thyroidectomy plus radioiodine) serum Tg was measured during TSH-suppressive thyroxine (T4) treatment (onT4-Tg). Patients with undetectable onT4-Tg and negative neck ultrasound (US) were considered disease free and onT4-Tg was measured every 12 months for a mean follow-up of 6.8 (4.7-8.9) years. Patients with an increase in onT4-Tg underwent specific diagnostic work-up and appropriate treatment if necessary. Results: Four patients showed recurrence at first follow-up visit with a corresponding increase in onT4-Tg concentrations (sensitivity 100%). Three patients had false positive onT4-Tg measurement (specificity 98%) with a spontaneous decrease within 3-6 months in all cases (specificity 100%). Three of 188 patients with undetectable serum onT4-Tg at first follow-up showed recurrence later with an increase in onT4-Tg as the first (ns2) or unique (ns1) sign of relapse (sensitivity 100%). Among 185 disease-free patients in

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Section: Discussionsupporting

confidence: 93%

Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma

Giovanella¹,

Maffioli

Ceriani

et al. 2009

Clinical Chemistry and Laboratory Medicine

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“…This could be an indication that the cut-off value of the old TgAb assay/recovery test was unreliable and that some of the negative Tg was due to the presence of TgAb not detected by the recovery test. However, Schlumberger et al (19) demonstrated that the use of several different TgAb methods and recovery tests for determination of TgAb was also not fully reliable since method-to-method variability existed despite standardization against the WHO standard. The inability to reliably detect interfering TgAb and Tg with different assay methods was also described by Spencer et al (20).…”

Section: Discussionmentioning

confidence: 99%

The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation

Phan

Jager

Wal

et al. 2008

European Journal of Endocrinology

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Objective: This retrospective study describes the role of serum thyroglobulin (Tg) in relation to tumor characteristics in the prediction of persistent/recurrent disease in patients with differentiated thyroid cancer (DTC) with negative Tg at the time of ablation. Design: Between 1989 and 2006, 94 out of 346 (27%) patients with DTC had undetectable Tg at the time of 131 I ablation and were included in this evaluation. The group of 94 patients consisted of 15 males and 79 females in the age range of 16-89 years with a median follow-up of 8 years (range 1-17). All medical records and follow-up parameters of the 94 patients were evaluated for the occurrence of persistent/recurrent disease. In patients with persistent/recurrent disease hematoxylineosin-stained slides of the primary tumors and/or metastatic lesions were also reviewed for histological features including immunostains for Tg. Results: During follow-up, 8 out of 94 (8.5%) patients showed persistent/recurrent disease: in the course of the disease two patients showed Tg positivity, three showed Tg antibody (TgAb) positivity, and the other three showed persistently undetectable Tg and TgAb. Patients who developed Tg and/or TgAb positivity during follow-up had a significantly shorter disease-free survival period when compared with patients with persistently undetectable Tg and TgAb (P!0.006). Histological features were not able to predict the recurrent status. Conclusions: Follow-up of Tg and TgAb in patients with initially negative Tg and TgAb is useful since a number of patients had shown detectable Tg or TgAb during follow-up indicative for persistent/recurrent disease. Tg and TgAb negativity at the time of ablation is not a predictive determinant for future recurrent status. 158 77-83 European Journal of Endocrinology

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“…Tg has been reported to be method dependent (56)(57)(58), and the interassay variation can vary between 43% and 65% in healthy subjects (35,57,59). To overcome interassay variation and allow for comparisons between studies, a certified Tg reference material (i.e., CRM-457) has been produced as a quality-control material for assay standardisation (60).…”

Section: Methods To Measure Tg Concentrationmentioning

confidence: 99%

Thyroglobulin as a Biomarker of Iodine Deficiency: A Review

Feei

Skeaff²

2014

Thyroid

132

110

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Background: Thyroglobulin, produced exclusively by the thyroid gland, has been proposed to be a more sensitive biomarker of iodine status than thyrotropin or the thyroid hormones triiodothyronine and thyroxine. However, evidence on the usefulness of thyroglobulin (Tg) to assess iodine status has not been extensively reviewed, particularly in pregnant women and adults. Summary: An electronic literature search was conducted using the Cochrane CENTRAL, Web of Science, PubMed, and Medline to locate relevant studies on Tg as a biomarker of iodine status. Since urinary iodine concentration (UIC) is the recommended method to assess iodine status in populations, only studies that clearly reported both Tg and UIC were included. For the purpose of this review, a median Tg <13 lg/L and a median UIC ‡100 lg/L (UIC ‡150 lg/L for pregnant women) were used to indicate adequate iodine status. We excluded studies conducted in subjects with either known thyroid disease or those with thyroglobulin antibodies. The search strategy and selection criteria yielded 34 articles of which nine were intervention studies. The majority of studies (six of eight) reported that iodine-deficient pregnant women had a median Tg ‡13 lg/L. However, large observational studies of pregnant women, including women with adequate and inadequate iodine status, as well as well-designed intervention trials that include both Tg and UIC, are needed. In adults, the results were equivocal because iodine-deficient adults were reported to have median Tg values of either <13 or ‡13 lg/L. Only studies in school-aged children showed that iodine-sufficient children typically had a median Tg <13 lg/L. Some of the inconsistent results may be partially explained by the use of different methodological assays and failure to assess assay accuracy using a certified reference material. Conclusions: These data suggest that Tg does hold promise as a biomarker of iodine deficiency. However, it is associated with limitations. A median Tg cutoff of 13 lg/L warrants further investigation, particularly in adults or pregnant women, as there is a lack of both observational and intervention studies in these groups.

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Comparison of Seven Serum Thyroglobulin Assays in the Follow-Up of Papillary and Follicular Thyroid Cancer Patients

Cited by 174 publications

References 27 publications

Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma

Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma

The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation

Thyroglobulin as a Biomarker of Iodine Deficiency: A Review

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