Monitoring Thyroglobulin in a Sensitive Immunoassay Has Comparable Sensitivity to Recombinant Human TSH-Stimulated Thyroglobulin in Follow-Up of Thyroid Cancer Patients

Smallridge, Robert C.; Meek, Shon; Morgan, Melissa A.; Gates, Geoffrey S.; Fox, Thomas P.; Grebe, Stefan K.; Fatourechi, Vahab

doi:10.1210/jc.2006-0993

Cited by 141 publications

(92 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Low functional sensitivity Tg assays have a higher sensitivity, but at the expense of a lower specificity (57,58). The future emergence of second generation Tg assays will probably reduce the need of TSH-stimulated Tg measurement in some patients (59).…”

Section: Low Functional Sensitivity Tg Assaysmentioning

confidence: 99%

Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer

Pitoia

Ward

Wohllk

et al. 2009

Arq Bras Endocrinol Metab

126

View full text Add to dashboard Cite

The aims of these recommendations were to develop clinical guidelines for evaluation and management of patients with differentiated thyroid cancer applicable to Latin American countries. The panel was composed by 13 members of the Latin American Thyroid Society (LATS) involved with research and management of thyroid cancer from different medical centers in Latin America. The recommendations were produced on the basis of the expert opinion of the panel with use of principles of Evidence-Based Medicine. Following a group meeting, a first draft based on evidences and the expert opinions of the panel was elaborated and, later, circulated among panel members, for further revision. After, this document was submitted to the LATS members, for commentaries and considerations, and, finally, revised and refined by the authors. The final recommendations presented in this paper represent the state of the art on management of differentiated thyroid cancer applied to all Latin American countries. Arq Bras Endocrinol Metab. 2009;53(7):884-97. KeywordśThyroid cancer; thyroid ultrasonography; radioiodine therapy; thyroglobulin; consensus RESUMO Estas recomendações tiveram por objetivo o desenvolvimento de diretrizes para avaliação e manejo de pacientes com câncer diferenciado da tiroide em países latino-americanos. Um painel composto por 13 membros da Sociedade Latino-Americana de Tireoide (SLAT) -que estavam envolvidos em pesquisas, e eram peritos no cuidado do paciente com câncer da tiroide e provenientes de diferentes centros médicos latino-americanos -utilizou os princípios da Medicina Baseada em Evidências para produzir esse consenso. Após uma primeira reunião, um texto inicial foi elaborado, baseado em evidências e opiniões dos especialistas do painel e, posteriormente, circulado entre os membros do painel, para revisão. Após a revisão, o documento foi enviado aos membros da SLAT para comentários e considerações e, finalmente, revisado e refinado pelos autores. As recomendações finais aqui apresentadas demonstram o estado da arte no manejo do câncer diferenciado da tireoide aplicadas aos países latino-americanos.Arq InTRODUCTIOn T he risk of malignancy in a thyroid nodule varies between 5% and 10% in iodine sufficient countries, and the amount of iodine supplemented in table salt influences on the morphology of the malignant tumor types (1).

show abstract

Section: Low Functional Sensitivity Tg Assaysmentioning

confidence: 99%

Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer

Pitoia

Ward

Wohllk

et al. 2009

Arq Bras Endocrinol Metab

126

View full text Add to dashboard Cite

show abstract

“…A further increase to 99% was obtained by coupling onT4-Tg and neck ultrasonography (US) (5). Globally, as confirmed even by using different high-sensitive Tg assays, few patients with undetectable onT4-Tg had a pathological Tg response (i.e., )2 ng/mL) to recombinant human TSH (rhTSH) stimulation, and less actually recurred (6,7). Otherwise, no prospective data are available (8).…”

Section: Introductionmentioning

confidence: 99%

Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma

Giovanella¹,

Maffioli

Ceriani

et al. 2009

Clinical Chemistry and Laboratory Medicine

View full text Add to dashboard Cite

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

show abstract

“…However, some authors have shown that TSH stimulation is not necessary when using second generation Tg assays with functional sensitivity of 0.1 to 0.3 ng/mL (30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

Development, characterization and clinical validation of new sensitive immunofluorometric assay for the measurement of serum thyroglobulin

Nakabashi

Biscolla

Kasamatsu

et al. 2012

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

OBJECTIVE: In the last decade, data published stressed the role of highly-sensitive thyroglobulin (Tg) assays in the follow-up of differentiated thyroid carcinoma (DTC) patients. The present study describes a new, highly-sensitive Tg assay, compares it with an available commercial assay, and validates it in the follow-up of DTC patients. SUBJECTS AND METHODS: The immunofluorometric high-sensitivity Tg assay is based on monoclonal and polyclonal antibodies produced at our laboratories. It was validated in 100 samples of 87 patients with DTC submitted to total thyroidectomy, 87% of whom also received radioiodine. For correlation, all samples were also tested using a commercial Tg assay (Beckman Access) with functional sensitivity (FS) of 0.1 ng/mL. RESULTS: The new method showed FS of 0.3 ng/mL. The correlation between the two methods was good (r = 0.74; p < 0.0001). The diagnostic sensitivity was 88.9%, and it was increased to 100% when combined with neck US. CONCLUSION: This new, high-sensitivity Tg assay presented a good correlation with Beckman Access assay and with the clinical outcome of the patients. The continuous availability of a validated assay is an additional advantage for long term follow-up of DTC patients. Arq Bras Endocrinol Metab. 2012;56(9):658-65

show abstract

Monitoring Thyroglobulin in a Sensitive Immunoassay Has Comparable Sensitivity to Recombinant Human TSH-Stimulated Thyroglobulin in Follow-Up of Thyroid Cancer Patients

Cited by 141 publications

References 18 publications

Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer

Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer

Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma

Development, characterization and clinical validation of new sensitive immunofluorometric assay for the measurement of serum thyroglobulin

Contact Info

Product

Resources

About