Ching-Jung Hsieh1, Pei-Wen Wang. 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine , Kaohsiung, Taiwan .
Abstract
OBJECTIVE: To investigate whether elevated and sequential changes in serum antithyroglobulin antibody (TgAb) levels are indicators of recurrence or persistence of papillary thyroid cancer (PTC) in patients with undetectable thyroglobulin. METHODS: In 56 patients followed for more than 7 years, we recorded all serum TgAb levels (except the ones determined within one year after (131)I therapy or diagnostic scans) and evaluated their disease status. All patients had undergone total thyroidectomy and remnant ablation by (131)I, and they were positive for TgAb and had undetectable thyroglobulin during follow-up. The sequential changes of TgAb were defined as persistently high, increasing, persistently medium, decreasing, and decreasing to negative. Recurrence or persistence of PTC was defined as active disease as assessed by (131)I scanning, (18)F-fluorodeoxyglucose positron emission tomography, ultrasonography, computed tomography, or surgical examination. RESULTS: Of the 56 patients enrolled, 10 patients had persistent PTC and 12 patients had recurrent PTC at more than 1 year after total thyroidectomy and (131)I therapy. TgAb was persistently high in 4 patients (3 with active PTC), increasing in 6 patients (4 with active PTC), persistently medium in 16 patients (12 with active PTC), decreasing in 5 patients (none with active PTC), and decreased to negative in 25 patients (3 with active PTC). According to the trend, the patients with persistently high TgAb, increasing TgAb, and persistently medium TgAb had active disease more often (p<0.001). In the multivariable regression analyses, the trend of TgAb change was a strong predictor of PTC activity (p<0.001, R(2)=-0.501). The most common diagnostic procedures performed for active disease were neck ultrasonography (21 patients) followed by (18)F-fluorodeoxyglucose positron emission tomography (11 patients). The patients with autoimmune thyroid disease had better prognoses than did the patients without autoimmune thyroid disease (18% active PTC vs. 53% active PTC, p=0.02). CONCLUSION: The presence of TgAb is indicative of an active tumor. Sequential TgAb change is a good predictor of disease prognosis and is helpful for clinical decision making.
OBJECTIVE: To investigate whether elevated and sequential changes in serum antithyroglobulin antibody (TgAb) levels are indicators of recurrence or persistence of papillary thyroid cancer (PTC) in patients with undetectable thyroglobulin. METHODS: In 56 patients followed for more than 7 years, we recorded all serum TgAb levels (except the ones determined within one year after (131)I therapy or diagnostic scans) and evaluated their disease status. All patients had undergone total thyroidectomy and remnant ablation by (131)I, and they were positive for TgAb and had undetectable thyroglobulin during follow-up. The sequential changes of TgAb were defined as persistently high, increasing, persistently medium, decreasing, and decreasing to negative. Recurrence or persistence of PTC was defined as active disease as assessed by (131)I scanning, (18)F-fluorodeoxyglucose positron emission tomography, ultrasonography, computed tomography, or surgical examination. RESULTS: Of the 56 patients enrolled, 10 patients had persistent PTC and 12 patients had recurrent PTC at more than 1 year after total thyroidectomy and (131)I therapy. TgAb was persistently high in 4 patients (3 with active PTC), increasing in 6 patients (4 with active PTC), persistently medium in 16 patients (12 with active PTC), decreasing in 5 patients (none with active PTC), and decreased to negative in 25 patients (3 with active PTC). According to the trend, the patients with persistently high TgAb, increasing TgAb, and persistently medium TgAb had active disease more often (p<0.001). In the multivariable regression analyses, the trend of TgAb change was a strong predictor of PTC activity (p<0.001, R(2)=-0.501). The most common diagnostic procedures performed for active disease were neck ultrasonography (21 patients) followed by (18)F-fluorodeoxyglucose positron emission tomography (11 patients). The patients with autoimmune thyroid disease had better prognoses than did the patients without autoimmune thyroid disease (18% active PTC vs. 53% active PTC, p=0.02). CONCLUSION: The presence of TgAb is indicative of an active tumor. Sequential TgAb change is a good predictor of disease prognosis and is helpful for clinical decision making.
Authors: Maria F Bates; Marcos R Lamas; Reese W Randle; Kristin L Long; Susan C Pitt; David F Schneider; Rebecca S Sippel Journal: Surgery Date: 2017-11-08 Impact factor: 3.982
Authors: Bryan R Haugen; Erik K Alexander; Keith C Bible; Gerard M Doherty; Susan J Mandel; Yuri E Nikiforov; Furio Pacini; Gregory W Randolph; Anna M Sawka; Martin Schlumberger; Kathryn G Schuff; Steven I Sherman; Julie Ann Sosa; David L Steward; R Michael Tuttle; Leonard Wartofsky Journal: Thyroid Date: 2016-01 Impact factor: 6.568
Authors: S Morbelli; G Ferrarazzo; E Pomposelli; F Pupo; G Pesce; I Calamia; F Fiz; A Clapasson; M Bauckneht; M Minuto; G Sambuceti; M Giusti; M Bagnasco Journal: J Endocrinol Invest Date: 2016-11-14 Impact factor: 4.256
Authors: Ari J Wassner; Margaret Della Vecchia; Petr Jarolim; Henry A Feldman; Stephen A Huang Journal: J Clin Endocrinol Metab Date: 2017-09-01 Impact factor: 5.958
Authors: A Ernaga-Lorea; M C Hernández-Morhain; E Anda-Apiñániz; J J Pineda-Arribas; I Migueliz-Bermejo; N Eguílaz-Esparza; A Irigaray-Echarri Journal: Clin Transl Oncol Date: 2017-10-25 Impact factor: 3.405