High serum thyroglobulin levels: Diagnostic indicators in patients with metastases from unknown primary sites

Abstract

Patients with metastases from differentiated thyroid carcinoma have a good chance of long-term survival when the diagnosis is prompt and appropriate therapy is applied early. This is also true for patients with metastases in the bone, taking into account that an appropriate therapy, usually 131-I, may be palliative in some cases. This study investigates whether serum thyroglobulin (Tg) measurement in patients with cold thyroid nodule and metastases from an unknown primary site could help identify a differentiated thyroid carcinoma. The results obtained show that Tg measurements is a useful adjunctive test when used with fine-needle aspiration biopsy. In particular, very high Tg levels point to metastatic thyroid cancer, whereas lower levels do not help determining whether metastatic cancer is of thyroid origin or not.

Circulating thyroglobulin measurements by homologous radioimmunoassay in dogs with thyroid carcinoma

“…Plasma Tg tended even to be slightly lower in dogs with distant mé¬ tastases than in dogs without (data not shown). This contrasts with studies in human thyroid cancer where the most elevated serum Tg levels were found in patients with distant métastases (18).…”

“…In humans, serum Tg levels may be increased in all thyroid disease (with the exception of athyroidism and Tg synthesis defects) (10)(11)(12)(13). Particularly in thyroid cancer very high levels can be found (14)(15)(16)(17)(18). However, in man, there is a great overlap be¬ tween Tg levels in normal individuals and cancer patients (19), as well as between cancer patients and patients with other thyroid illnesses (13,20).…”

CEA, AFP, CA125, CA153 and CA199 in Malignant Pleural Effusions Predict the Cause

“…in isolated axillary node adenocarcinomas and in peritoneal papillary adenocarcinomatosis, respectively. In all other cases, routine evaluation of commonly used epithelial serum tumor markers (CEA, CA199, CA 153, CA125) has no proven prognostic or diagnostic value, and non-specific elevations of multiple markers occurs in the majority of CUP patients (Panza et al, 1987;Pavlidis et al, 1994). Currently, there are few studies on PE tumor markers in detection of CUP, meanwhile, few tumor markers are evaluated in diagnosing different causes of MPEs.…”

Tumormarker für Schilddrüsenkarzinome

“…Doch auch das Ergebnis einer einzelnen hTg-Bestimmung kann in ausgewählten Fällen zumindest eine zusätzliche Entscheidungshilfe bezüglich des Vorliegens eines Schilddrüsenmalignoms liefern. Bei der Abklärung eines Tumorleidens mit unbekanntem Primarius ("CUP-Syndrom") muss bei einem sehr hohen hTg-Wert an ein thyreoidales Follikelzellkarzinom als Primärtumor gedacht werden [15,66,80], wobei sich die hTg-Bestimmung hier insbesondere bei zusätzlichem Vorliegen eines suspekten Schilddrüsenknotens anbietet. Bei CUP-Patienten mit Fernmetastasen und Struma nodosa wurde für die hTg-Bestimmung ein positiver prädiktiver Wert von 81 % und ein negativer Vorhersagewert von 100 % ermittelt [80]; vor allem bei ossären Filiae sind fast immer exzessiv hohe hTg-Werte messbar [15].…”