Serum-Thyreoglobulinspiegel als Tumormarker bei Schilddrüsencarcinom

Abstract

For evaluating the clinical significance of thyroglobulin measurements for the follow-up of patients with differentiated thyroid carcinoma, thyroglobulin was determined radioimmunologically during the past 2 years (up to 12 times) in 40 patients after withdrawal of thyroid hormone. Thyroglobulin values were compared with whole-body scintigrams after radioiodine. Thyroglobulin antibodies, which may interfere in the radioimmunoassay for thyroglobulin, were also estimated by a radioimmunologic method. In the majority of cases, thyroglobulin levels corresponded to the scintigrams, however, the thyroglobulin level appeared to be a more precise index for changes in tumor tissue mass. In one patient the scintigram was negative, whereas considerable amounts of thyroglobulin were measured in the serum: X-ray tomography revealed a lung metastase in this case. On the other hand, thyroglobulin was undetectable in the sera of patients who exhibited distinct metastases in the scintigram. Thyroglobulin can be regarded as a tumor marker in patients thyroidectomized for differentiated thyroid carcinoma. However, its determination can certainly not replace whole-body scintigraphy as postulated by several authors, although thyroglobulin measurement appears to be superior to scanning in some cases. A combined application of iodine scanning and thyroglobulin radioimmunoassay is thus advisable in the follow-up of patients with differentiated thyroid carcinoma.

Radioimmunoassay for Serum Thyroglobulin Designed for Early Detection of Metastases and Recurrencies in the Follow-Up of Patients with Differentiated Thyroid Carcinoma

“…5). The reference r nge is in accordance with the literature (8,30). However, lower normal human thyroglobulin ranges have been reported (13,17,21).…”

“…The assay is mainly employed in the follow-up of patients with differentiated thyroid carcinoma to detect early metastases and recurrencies. I3I I scans in connection with the measurement of serum thyroglobulin proved to be most reliable in the follow-up of those patients (7)(8)(9)(10)(11). Some authors (6,(12)(13)(14), have even proposed a reduction of scanning frequency after treatment if regul r thyroglobuiin measurements are performed.…”

Serum Thyroglobulin Determinations in Patients with Differentiated Thyroid Carcinoma

“…On the other hand, in distant metastases particularly in bones and lungs, falsely negative results were rare as also reported by other authors (24,29,43,54), while the TG values were rather high (24,29,35,43,50,54,58). (34,51,53,54). Charles (20) identified from the data of 1222 subjects available in the literature 5% patients who after a partial thyroidectomy accumulated radioiodine in the remaining thyroid tissue without any signs of malignancy and had serum TG levels above the "critical" value, i.e.…”

“…The presence of non-functioning metastases of thyroid cancer undetectable by scanning, which could be detected by means of the serum TG determination, is a serious problem. Their occurrence was reported by many authors (17,31,35,44,51,59), but always only a relative small number of cases with low or undetectable TG has been dealt with. In our patients, 45 subjects, i.e.…”

Serum-Thyreoglobulin in der Metastasendiagnostik des differenzierten Schilddrüsenkarzinoms

“…Nucl.-Med. fluß wird für die Praxis der Nachsorgediagnostik unterschiedlich bewertet (1-5, 8,12,13,28,33,37). In unserer Studie fanden wir, daß das S-TG von papillären Schilddrüsenkarzinommetastasen stärker supprimierbar war als von follikulären und bei kleinen papillären Karzinomen unter die Nachweisgrenze geriet.…”