Comparing the efficacy of thyroglobulin and thyroglobulin/ thyroid-stimulating hormone ratio models in predicting a successful response to radioactive iodine therapy

Abstract

Background The thyroglobulin (Tg)/ thyroid-stimulating hormone (TSH) ratio has manifested to be a reliable marker for predicting prognosis in patients with differentiated thyroid carcinoma (DTC). The objective of this study was to compare the efficacy of Tg and Tg/TSH ratio models in predicting a successful response to radioactive iodine therapy. Methods One thousand six hundred forty-two DTC patients receiving 131I radiotherapy were finally enrolled in this retrospective study. The patients were divided into a training set (n = 973) and a validation set (n = 669) by the patient consultation time (July 2019). A receiver-operating characteristic curve was constructed for Tg and the Tg/TSH ratio to establish their cutoffs. Then, the variables were screened by univariate logistic regression and incorporated into logistic prediction models by stepwise regression, where Tg/TSH was excluded from model 1 and Tg was excluded from model 2. Results In 1642 enrolled DTC patients, the first 131I radiotherapy had an excellent response in 855 patients. The cut-offs for Tg level and Tg/TSH ratio were 3.40 ng/ mL [area under the curve (AUC): 0.789] and 36.03 ng/mIU (AUC: 0.788), respectively. In addition, the AUC of the model including Tg was higher than that of the model including Tg/TSH in both the training set (0.837 vs 0.833) and the testing set (0.854 vs 0.836). Conclusions Both Tg and Tg/TSH ratios could be considered predictors of the effects of the first 131I ablative therapy. However, the prediction model including Tg performed better than the model including Tg/TSH.

Comparison of Models Predicting Efficacy of Radioiodine Therapy in Patients with Differentiated Thyroid Cancer

“…It con rms and expands the conclusions of Ju et al who compared models including Tg and Tg/TSH showing that both Tg and Tg/TSH rations could be considered predictors of the effects of RAI. However, in their study, the prediction model including Tg performed even better than model including Tg/TSH [29] The cut-off for Tg concentration to predict a persistent disease suggested in previous studies varied from 0.27 to 30 mg/l. In a meta-analysis by Webb et al [50], which included 15 studies involving 3900 patients, a cut-off of 10 mg/L was determined, demonstrating a good negative predictive value (NPV).…”

“…Due to the potential stimulation of Tg production by TSH, Tg concentrations in pre-RAI therapy patients may be in uenced by their TSH levels [29]. Consequently, extensive research has been conducted on the correlation between the Tg/TSH ratio and the outcomes of initial RAI therapy [27,30,45].…”

“…Consequently, extensive research has been conducted on the correlation between the Tg/TSH ratio and the outcomes of initial RAI therapy [27,30,45]. The study of Ju et al compared the predictive model capability to the RAI ablation therapy of Tg and Tg/TSH [29].…”

“…According to their results, while both Tg concentrations and Tg/TSH ratios could serve as predictors for the outcomes of the initial 131I ablative therapy, the model incorporating Tg alone exhibited superior performance compared to the model incorporating Tg/TSH ratios [29].…”

A novel nomogram integrated with preablation stimulated thyroglobulin and thyroglobulin/thyroid-stimulating hormone ratio to predict the therapeutic response of intermediate‑ and high‑risk differentiated thyroid cancer patients: a bi-center retrospective study

“…Previous studies pointed out that the recurrence rate of patients with ER was only 1-4% [5]. In addition, a series of studies demonstrated that the stimulated thyroglobulin (sTg), which is obtained as early as a few weeks after surgery is correlated to the recurrence and development of cancer [6][7][8][9]. However, the relationship between sTg and the therapeutic response to RAI is still unknown.…”