Jae Hoon Moon1, June Young Choi2, Woo-Jin Jeong3, Soon-Hyun Ahn3, Won Woo Lee4, Kyoung Min Kim1, Sung Hee Choi1, Soo Lim1, Young Joo Park5, Ka Hee Yi6, Do Joon Park5, Hak Chul Jang1. 1. Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Korea. 2. Department of Surgery, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea. 3. Department of Otorhinolaryngology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea. 4. Department of Nuclear Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Korea. 5. Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea. 6. Department of Internal Medicine, Seoul National University Boramae Medical Center and Seoul National University College of Medicine, Seoul, Korea.
Abstract
OBJECTIVE: We investigated the value of the stimulated thyroglobulin (Tg) level at the time of recombinant human thyrotropin (rhTSH)-aided remnant ablation for predicting disease status 1 year later in patients with DTC who underwent total thyroidectomy with central neck dissection (CND). DESIGN, SETTING, AND PARTICIPANT: This was a prospective observational study of 253 consecutive patients with DTC who underwent rhTSH-aided RAI ablation after total thyroidectomy and prophylactic CND. Patients with evidence of initial distant metastasis or positive Tg antibodies were excluded. MAJOR OUTCOME MEASURE: We compared rhTSH-stimulated Tg level at RAI ablation according to the disease status at 1 year and evaluated optimal cut-off value of rhTSH-stimulated Tg. Binary logistic regression analysis was performed to investigate the independent predictive factors for disease status 1 year after ablation. RESULTS: Among study participants, 228 (90·1%) were considered disease free at 1 year after remnant ablation. Patients with persistent or recurrent disease were more likely to be aged ≥45 years, and to have N1b stage, TNM stage III or IV, and higher rhTSH-stimulated Tg level at RAI ablation. The optimal cut-off of rhTSH-stimulated Tg for predicting persistent or recurrent disease was 1·79 ng/ml, with a negative predictive value of 99·5%. A serum rhTSH-stimulated Tg level ≥1·79 at the time of ablation was independently associated with persistent or recurrent disease 1 year later. N1b stage tended to be associated with persistent or recurrent disease. CONCLUSION: A low stimulated serum Tg level at rhTSH-aided RAI ablation may be a favourable prognostic marker in the setting of prophylactic CND.
OBJECTIVE: We investigated the value of the stimulated thyroglobulin (Tg) level at the time of recombinant human thyrotropin (rhTSH)-aided remnant ablation for predicting disease status 1 year later in patients with DTC who underwent total thyroidectomy with central neck dissection (CND). DESIGN, SETTING, AND PARTICIPANT: This was a prospective observational study of 253 consecutive patients with DTC who underwent rhTSH-aided RAI ablation after total thyroidectomy and prophylactic CND. Patients with evidence of initial distant metastasis or positive Tg antibodies were excluded. MAJOR OUTCOME MEASURE: We compared rhTSH-stimulated Tg level at RAI ablation according to the disease status at 1 year and evaluated optimal cut-off value of rhTSH-stimulated Tg. Binary logistic regression analysis was performed to investigate the independent predictive factors for disease status 1 year after ablation. RESULTS: Among study participants, 228 (90·1%) were considered disease free at 1 year after remnant ablation. Patients with persistent or recurrent disease were more likely to be aged ≥45 years, and to have N1b stage, TNM stage III or IV, and higher rhTSH-stimulated Tg level at RAI ablation. The optimal cut-off of rhTSH-stimulated Tg for predicting persistent or recurrent disease was 1·79 ng/ml, with a negative predictive value of 99·5%. A serum rhTSH-stimulated Tg level ≥1·79 at the time of ablation was independently associated with persistent or recurrent disease 1 year later. N1b stage tended to be associated with persistent or recurrent disease. CONCLUSION: A low stimulated serum Tg level at rhTSH-aided RAI ablation may be a favourable prognostic marker in the setting of prophylactic CND.
Authors: Mijin Kim; Min Ji Jeon; Won Gu Kim; Jong Jin Lee; Jin Sook Ryu; Eun Jung Cho; Dae Hyun Ko; Woochang Lee; Sail Chun; Won Ki Min; Tae Yong Kim; Young Kee Shong; Won Bae Kim Journal: Endocrinol Metab (Seoul) Date: 2016-08-02
Authors: Aleksandra Ledwon; Ewa Paliczka-Cieślik; Aleksandra Syguła; Tomasz Olczyk; Aleksandra Kropińska; Agnieszka Kotecka-Blicharz; Kornelia Hasse-Lazar; Aneta Kluczewska-Gałka; Barbara Jarząb; Daria Handkiewicz-Junak Journal: Ann Nucl Med Date: 2021-08-07 Impact factor: 2.668