Patients with differentiated thyroid cancer have a venous gradient in thyroglobulin levels

Abstract

BACKGROUND.Although serum thyroglobulin (Tg) is an excellent marker for detecting recurrent or persistent differentiated thyroid cancer (DTC), it is unreliable in patients who have positive anti‐Tg antibodies. Furthermore, a growing number of patients with DTC have elevated Tg levels but no detectable disease on radioiodine scanning or other imaging studies. The objective of this study was to determine whether a gradient in Tg protein level exists in patients with DTC.METHODS.Fifteen patients who underwent thyroidectomy and/or lymph node dissection for primary DTC (n = 10 patients) and recurrent or persistent DTC (n = 5 patients). A venipuncture was performed simultaneously from the internal jugular vein adjacent to the tumor and the ipsilateral antecubital vein. Venous Tg protein levels were measured by using a chemiluminescence assay.RESULTS.The average internal jugular‐to‐antecubital vein Tg protein ratio was 3.4:1.0 (median Tg ratio, 2.9:1; range, 0.8–62.2). Four patients had positive anti‐Tg antibodies but still had a Tg gradient. Tg levels were significantly higher in the adjacent internal jugular vein than in the antecubital vein (P = .0019). The Tg ratio between the internal jugular and antecubital veins was significantly higher in patients with recurrent or persistent DTC than in patients with primary tumors (P = .0196).CONCLUSIONS.To the authors' knowledge, this is the first study to document a venous gradient in Tg protein levels in patients with DTC. The findings suggested that venous sampling for Tg may be used to localize DTC in some patients who have high or increasing serum Tg levels but negative radioiodine scans or imaging studies. Cancer 2007 © 2007 American Cancer Society.

The combined use of miRNAs and mRNAs as biomarkers for the diagnosis of papillary thyroid carcinoma

“…Furthermore, conventional histology fails to provide prognostic and therapeutic information for TC. Some biomarkers, such as thyroglobulin (Tg) (7,8), galectin-3 (9) and HBME-1 (10), have been used in clinical practice for the diagnosis of PTC; however, the sensitivity and specificity of these biomarkers are low, and only a small fraction of these biomarkers can be used as diagnostic or prognostic biomarkers. Therefore, it is essential to develop novel diagnostic and prognostic biomarkers for PTC.…”

Is there any venous gradient in serum thyroglobulin levels in patients with differentiated thyroid cancer?

“…Serum Tg level is the most commonly used biochemical marker to detect the persistent or recurrent disease in patients with DTC. It was reported that approximately 15% of thyroid cancer survivors have Tg-positive but radioiodine-negative tumors [9]. Thus, documentation of a venous gradient in Tg levels in patients with DTC is a new investigational topic.…”

“…However, the role of venous sampling for Tg in patients with DTC is not clearly known. In a recent study, Kebebew and Reiff showed that 15 patients who underwent thyroidectomy and/or lymph node dissection for primary and persistent or recurrent DTC had a venous gradient in Tg levels, and also they suggested that venous sampling for Tg may be used to localize DTC in patients who have high or increasing Tg levels but negative imaging studies [9]. Similarly, according to the results of this study, there is a significant venous gradient between the Tg levels of venous samples adjacent to primary tumor and distant circulation in patients with DTC.…”

Study of Thyroid Cancer

“…Among the 24 patients in the study 22 patients had well differentiated carcinomas [3] of follicular cell origin. These patients were categorized into low and high risk groups based on the AMES categorization scheme [10].…”