Factors Influencing the Basal and Recombinant Human Thyrotropin-Stimulated Serum Thyroglobulin in Patients with Metastatic Thyroid Carcinoma

Abstract

The serum thyroglobulin (Tg) level is the most sensitive marker for detecting residual thyroid carcinoma. We hypothesized that the basal and TSH-stimulated Tg levels in patients with metastatic thyroid carcinoma would reflect tumor volume, histological subtype, and location of metastatic lesions. A retrospective review of 417 thyroid cancer survivors undergoing evaluation for residual disease with the assistance of recombinant human TSH (rhTSH) was performed. In 169 patients with metastatic disease, we found that the basal Tg level directly correlated with the number of lesions, and that it was highest in patients with follicular and lowest in those with papillary thyroid carcinoma. The basal Tg level was highest in patients with bone metastases and lowest in those with cervical metastases. The fold increase in the serum Tg after rhTSH treatment was highest in papillary thyroid carcinoma and lowest in Hurthle cell carcinoma. The fold increase in Tg was not influenced by tumor volume or by the site of metastatic lesions. Multivariate analysis showed multiple interactions between factors, but did not identify one factor that significantly influenced basal Tg or fold increase. We conclude that the location and volume of metastases influence basal Tg, but not its responsiveness to rhTSH, whereas the histological type of carcinoma influences both basal Tg and responsiveness to rhTSH.

Clinical Utility of 18F-FDG PET/CT Concurrent with 131I Therapy in Intermediate–to–High-Risk Patients with Differentiated Thyroid Cancer: Dual-Center Experience with 286 Patients

“…The serum thyroglobulin level is only indicative of the presence of DTC lesions and tumor burden irrespective of tumor differentiation (29)(30)(31)(32). Furthermore, some patients with positive PET/CT findings in the present study had low serum thyroglobulin levels of , 10.0 ng/mL with TSH stimulation, suggesting that DTC patients with low serum thyroglobulin levels can also have positive PET/CT findings.…”

Early prognostic factors at the time of diagnosis of bone metastasis in patients with bone metastases of differentiated thyroid carcinoma

“…Therefore, the timing of diagnosis of bone metastases could be an important prognostic indicator that predicts the survival of DTC patients. The TSH-stimulated serum Tg level is known to be associated with the disease volume in DTC patients (15,19,20). A higher stimulated serum Tg level at the time of the detection of distant metastasis is known to be a significant predictor of poor outcomes (15,21).…”

Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer

“…Following surgery and 131 I therapy, serum Tg levels serve as a sensitive marker of residual or recurrent disease (280)(281)(282)(283); the magnitude of serum Tg elevation appears to correlate with the site(s) of metastatic disease and with the tumor subtype (280).…”