Clinical relevance of highly sensitive Tg assay in monitoring patients treated for differentiated thyroid cancer

Iervasi, Annalisa; Iervasi, Giorgio; Ferdeghini, M; Solimeo, C.; Bottoni, Antonio; Rossi, Leonardo; Colato, Chiara; Zucchelli, G.C.

doi:10.1111/j.1365-2265.2007.02907.x

Cited by 80 publications

(68 citation statements)

References 33 publications

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“…In clinical practice it is realistically difficult to use many different assay methods in all patients who initially showed undetectable serum Tg or TgAb. However, our study and recently published studies (21,22) had shown that retesting or follow-up of Tg using different assay methods is useful in patients with initially negative Tg since some patients had demonstrated detectable Tg during follow-up indicative for recurrent disease (Table 3).…”

Section: Discussionmentioning

confidence: 65%

The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation

Phan

Jager

Wal

et al. 2008

European Journal of Endocrinology

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Objective: This retrospective study describes the role of serum thyroglobulin (Tg) in relation to tumor characteristics in the prediction of persistent/recurrent disease in patients with differentiated thyroid cancer (DTC) with negative Tg at the time of ablation. Design: Between 1989 and 2006, 94 out of 346 (27%) patients with DTC had undetectable Tg at the time of 131 I ablation and were included in this evaluation. The group of 94 patients consisted of 15 males and 79 females in the age range of 16-89 years with a median follow-up of 8 years (range 1-17). All medical records and follow-up parameters of the 94 patients were evaluated for the occurrence of persistent/recurrent disease. In patients with persistent/recurrent disease hematoxylineosin-stained slides of the primary tumors and/or metastatic lesions were also reviewed for histological features including immunostains for Tg. Results: During follow-up, 8 out of 94 (8.5%) patients showed persistent/recurrent disease: in the course of the disease two patients showed Tg positivity, three showed Tg antibody (TgAb) positivity, and the other three showed persistently undetectable Tg and TgAb. Patients who developed Tg and/or TgAb positivity during follow-up had a significantly shorter disease-free survival period when compared with patients with persistently undetectable Tg and TgAb (P!0.006). Histological features were not able to predict the recurrent status. Conclusions: Follow-up of Tg and TgAb in patients with initially negative Tg and TgAb is useful since a number of patients had shown detectable Tg or TgAb during follow-up indicative for persistent/recurrent disease. Tg and TgAb negativity at the time of ablation is not a predictive determinant for future recurrent status. 158 77-83 European Journal of Endocrinology

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Section: Discussionmentioning

confidence: 65%

The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation

Phan

Jager

Wal

et al. 2008

European Journal of Endocrinology

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“…Despite debates on the discordance between commercial assay kits [2][3][4][5][6], highsensitivity human Tg IRMA can detect serum Tg concentrations of 0.2 ng/ml, and serum Tg concentrations <0.2 ng/ml are used to indicate complete remission [7]. Because the serum Tg level is used for surveillance after total thyroidectomy to evaluate the residual and recurrent differentiated thyroid cancer (DTC), accurate estimation of the serum Tg level is important [8].…”

Section: Introductionmentioning

confidence: 99%

Does 131I Radioactivity Interfere with Thyroglobulin Measurement in Patients Undergoing Radioactive Iodine Therapy with Recombinant Human TSH?

Bang

Lee

Kim

2015

Nucl Med Mol Imaging

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Objectives Recombinant human thyroid-stimulating hormone (rhTSH) is widely used in radioactive iodine therapy (RIT) to avoid side effects caused by hypothyroidism during the therapy. Owing to RIT with rhTSH, serum thyroglobulin (Tg) is measured with high 131 I concentrations. It is of concern that the relatively high energy of 131 I could interfere with Tg measurement using the immunoradiometric assay (IRMA). We investigated the effect of 131 I administration on Tg measurement with IRMA after RIT. Methods A total of 67 patients with thyroid cancer were analysed retrospectively. All patients had undergone rhTSH stimulation for RIT. The patients' sera were sampled 2 days after 131 I administration and divided into two portions: for Tg measurements on days 2 and 32 after 131 I administration. The count per minute (CPM) of whole serum (200 μl) was also measured at each time point. Student's paired t-test and Pearson's correlation analyses were performed for statistical analysis. Results Serum Tg levels were significantly concordant between days 2 and 32, irrespective of the serum CPM. Subgroup analysis was performed by classification based on the 131 I dose. No difference was noted between the results of the two groups.Conclusions IRMA using 125 I did not show interference from 131

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“…A further increase to 99% was obtained by coupling onT4-Tg and neck ultrasonography (US) (5). Globally, as confirmed even by using different high-sensitive Tg assays, few patients with undetectable onT4-Tg had a pathological Tg response (i.e., )2 ng/mL) to recombinant human TSH (rhTSH) stimulation, and less actually recurred (6,7). Otherwise, no prospective data are available (8).…”

Section: Introductionmentioning

confidence: 99%

Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma

Giovanella¹,

Maffioli

Ceriani

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: Thyroglobulin (Tg) measurement following thyrotropin (TSH) stimulation is used in the follow-up of patients with differentiated thyroid carcinoma (DTC). However, high-sensitive assays allow accurate measurement of serum Tg even without TSH stimulation. Here, we prospectively evaluated the impact of unstimulated high-sensitive Tg measurement in early and long-term outcome of patients with DTC. Methods: One hundred and ninety five patients affected with DTC were evaluated. Six months after thyroid ablation (i.e., thyroidectomy plus radioiodine) serum Tg was measured during TSH-suppressive thyroxine (T4) treatment (onT4-Tg). Patients with undetectable onT4-Tg and negative neck ultrasound (US) were considered disease free and onT4-Tg was measured every 12 months for a mean follow-up of 6.8 (4.7-8.9) years. Patients with an increase in onT4-Tg underwent specific diagnostic work-up and appropriate treatment if necessary. Results: Four patients showed recurrence at first follow-up visit with a corresponding increase in onT4-Tg concentrations (sensitivity 100%). Three patients had false positive onT4-Tg measurement (specificity 98%) with a spontaneous decrease within 3-6 months in all cases (specificity 100%). Three of 188 patients with undetectable serum onT4-Tg at first follow-up showed recurrence later with an increase in onT4-Tg as the first (ns2) or unique (ns1) sign of relapse (sensitivity 100%). Among 185 disease-free patients in

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Clinical relevance of highly sensitive Tg assay in monitoring patients treated for differentiated thyroid cancer

Abstract: The use of a highly sensitive Tg assay may represent a useful diagnostic tool for improving the interpretation of Tg results during monitoring of DTC-treated patients for the early detection of recurrence and for optimizing the use of the more expensive rh-TSH test.

Cited by 80 publications

References 33 publications

The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation

The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation

Does 131I Radioactivity Interfere with Thyroglobulin Measurement in Patients Undergoing Radioactive Iodine Therapy with Recombinant Human TSH?

Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma

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