Serum thyroglobulin antibody levels within or near to the reference range may interfere with thyroglobulin measurement

Lőcsei, Zoltán; Szabolcs, I.; Rácz, Kàroly; Kovaćs, Gábor L.; Horváth, Dorottya; Toldy, Erzsébet

doi:10.11613/bm.2012.038

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…Data found in the literature indicated that in the presence of TgAb, values of Tg determined by immunoradiometric assay are usually lower than real values, even if the concentrations of TgAb are very low [5, 9, 19]. In previous reports, we observed an erroneously low measured Tg value according to the presence of TgAb, and the degree showed positive correlation with concentration of TgAb [3, 4].…”

Section: Discussionmentioning

confidence: 76%

“…It had been generally regarded that TgAb titer measured is below a clinical threshold will not be a significant influence on the Tg outcome; however, recent studies demonstrated that TgAb below the cut off can interfere the Tg outcome [19, 21]. Recently, Locsei et al also reported that the measured Tg value of patients serum can be influenced by mixing sheep TgAb in the reference range of TgAb concentration and deduced an equation estimating true Tg concentration using TgAb concentration in the same sample [9]. They proved the general concept of TgAb influence on the Tg measurement; however, their equation cannot be generally applied to clinical practice due to difference between sheep TgAb and human TgAb.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it has been also known that Tg radioimmunoassay is less prone to the influence than other immunometric assays. Recently, Locsei et al reported that decrease of measured Tg concentration by adding sheep TgAb from the electrochemiluninometric Tg assay and the magnitude of the influence was significant even in the reference range [9]. …”

Section: Introductionmentioning

confidence: 99%

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Estimation of True Serum Thyroglobulin Concentration Using Simultaneous Measurement of Serum Antithyroglobulin Antibody

Ahn

Lee

Jeong

et al. 2013

International Journal of Endocrinology

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We investigated the analytical interference of antithyroglobulin antibody (TgAb) to thyroglobulin (Tg) measurement and tried to convert measured Tg concentration to true Tg concentration using a mathematical equation which includes a concentration of TgAb. Methods. Tg was measured by immunoradiometric assay and TgAb by radioimmunoassy. Experimental samples were produced by mixing Tg and TgAb standard solutions or mixing patients' serum with high Tg or high TgAb. Mathematical equations for prediction of expected Tg concentration with measured Tg and TgAb concentrations were deduced. The Tg concentration calculated using the equations was compared with the expected Tg concentration. Results. Measured Tg concentrations of samples having high TgAb were significantly lower than their expected Tg concentration. Magnitude of TgAb interference with the Tg assay showed a positive correlation with concentration of TgAb. Mathematical equations for estimation of expected Tg concentration using measured Tg and TgAb concentrations were successfully deduced and the calculated Tg concentration showed excellent correlation with expected Tg concentration. Conclusions. A mathematic equation for estimation of true Tg concentration using measured Tg and TgAb concentration was deduced. Tg concentration calculated by use of the equation might be more valuable than measured Tg concentration in patients with differentiated thyroid cancer.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Estimation of True Serum Thyroglobulin Concentration Using Simultaneous Measurement of Serum Antithyroglobulin Antibody

Ahn

Lee

Jeong

et al. 2013

International Journal of Endocrinology

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“…However, circulating Tg antibodies (TgAb) can confound conventional Tg assays and thereby prevent accurate measurement of Tg levels (2,3). TgAb therefore represent a significant clinical issue in thyroid cancer monitoring (4).…”

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confidence: 99%

Prevalence and Significance of Thyroglobulin Antibodies in Pediatric Thyroid Cancer

Wassner

Vecchia

Jarolím

et al. 2017

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context: Circulating thyroglobulin antibodies (TgAb) can confound measurement of serum thyroglobulin and impair thyroid cancer surveillance. Few data exist on the significance of TgAb in pediatric thyroid cancer.Objective: To describe the prevalence, natural history, and clinical significance of TgAb in children with thyroid cancer.Design: Retrospective cohort study.Setting: Single academic pediatric center.Patients: Seventy-three consecutive children (#18 years) with nonmedullary thyroid cancer who had serum TgAb measured within 6 months after diagnosis.Main Outcome Measures: Prevalence and natural history of TgAb; association of TgAb status and resolution with patient and disease characteristics.Results: TgAb were detected in 41% of subjects (30 of 73) and were associated with lymph node metastasis (83% vs 53%, P = 0.01) but not distant metastasis. In patients with TgAb, resolution occurred in 44% (11 of 25) over a median follow-up of 3.8 years. Median time to clear TgAb was 10.7 months, and 10 of 11 patients who cleared (91%) did so within 2 years. Resolution of TgAb was associated with lower initial TgAb level (median 4.5 vs 76 normalized units, P = 0.003). TgAb positivity at diagnosis was not independently associated with persistent or recurrent disease (odds ratio 3.20, 95% confidence interval 0.95 to 10.80, P = 0.06).Conclusions: TgAb are common at diagnosis in children with thyroid cancer but resolve in nearly half of patients within 1 to 2 years. TgAb are associated with the presence of lymph node metastasis at diagnosis, but the long-term prognostic significance remains to be determined. (J Clin Endocrinol Metab 102: [3146][3147][3148][3149][3150][3151][3152][3153] 2017) T hyroid cancer is the most common endocrine malignancy in both children and adults. Although the risk of mortality from thyroid cancer is low, lifelong surveillance is mandatory due to the risk of disease recurrence, which may occur many years after initial treatment and apparent cure. This issue is especially salient in children with thyroid cancer because of the decades of monitoring required.Because many differentiated thyroid cancers produce thyroglobulin (Tg), measurement of serum Tg can detect thyroid cancer recurrence or progression and is therefore an important element of long-term surveillance in patients with thyroid cancer (1). However, circulating Tg antibodies (TgAb) can confound conventional Tg assays and thereby prevent accurate measurement of Tg levels (2, 3). TgAb therefore represent a significant clinical issue Abbreviations: NED, no evidence of disease; OR, odds ratio; RAI, radioactive iodine; Tg, thyroglobulin; TgAb, Tg antibody. 3146https://academic.oup.com/jcem

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“…These have been widely accepted management protocols [1] [2]. However, the presence of serum anti-Tg antibody (TgAb) may interfere with Tg measurement made by immunometric assay (IMA) or radioimmunoassay (RIA) methods and cause false results [3] [4] [5] [6]. In the presence of TgAb, IMA methods consistently underestimate serum Tg levels, while RIA methods generally overestimate serum TG levels [5] [6] [7].…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Value of Serum TgAb in the Tg-Negative and TgAb-Positive DTC Patients after Successful Ablation

Qing¹,

Su²,

Kuang³

2016

JCT

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Objective: The aim of this retrospective study was to evaluate diagnostic accuracy of serum thyroglobulin antibody (TgAb) in thyroglobulin (Tg)-negative and TgAbpositive (Tg − TgAb + ) patients with differentiated thyroid carcinoma (DTC). Method: We studied 341 patients with histologically confirmed DTC who had undergone remnant ablation and showed Tg − TgAb + assessed by electrochemiluminescence immunoassay (ECLIA). The cases were divided into two groups, including recurrence group 119 cases and no evidence of disease (NED) group 222 cases. Receiver operating characteristic (ROC) curve analysis was carried out. The symmetric measures of the two diagnostic methods (the golden standard and the diagnostic standard as serum TgAb level alone) were analyzed using McNemar test and measure of agreement Kappa. Results: Serum TgAb level (1381.292 ± 1017.221) IU/ml of patients with recurrent group was significantly higher than that (125.559 ± 314.047) IU/ml of NED group (P = 0.000 < 0.001). The area under the ROC curve was 0.962 and its asymptotic 95% confidence interval (CI) was (0.942, 0.982) that was high statistical significance. The cut-off value of TgAb was determined and interpreted at 246.695 IU/ml with sensitivity (92.40%) and specificity (92.30%). McNemar test showed that the diagnostic results of the two methods were not significant difference (P = 0.230 > 0.05). Measure of agreement Kappa was 0.841, P = 0.000 < 0.001 that showed the agreement of the two diagnostic methods was significant. Conclusion: Serum TgAb is a useful tumor marker for recurrence in Tg-negative and TgAb-positive DTC patients who underwent thyroidectomy and remnant ablation. The cut-off value of TgAb is 246.695 IU/ml, that is to say, serum TgAb level upon 246.695 IU/ml may be associated with the persistence or recurrence of DTC.

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Serum thyroglobulin antibody levels within or near to the reference range may interfere with thyroglobulin measurement

Cited by 8 publications

References 10 publications

Estimation of True Serum Thyroglobulin Concentration Using Simultaneous Measurement of Serum Antithyroglobulin Antibody

Estimation of True Serum Thyroglobulin Concentration Using Simultaneous Measurement of Serum Antithyroglobulin Antibody

Prevalence and Significance of Thyroglobulin Antibodies in Pediatric Thyroid Cancer

The Diagnostic Value of Serum TgAb in the Tg-Negative and TgAb-Positive DTC Patients after Successful Ablation

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