Prognostic Value and Dynamics of Antithyroglobulin Antibodies for Differentiated Thyroid Carcinoma

Sun, Dongdong; Zheng, Xiangqian; He, Xianghui; Huang, Chao; Jia, Qiang; Tan, Jian; Zheng, Wei; Li, Ning; Wang, Peng; Wang, Renfei; Liu, Ming; Zhao, Li; Yuan, Shukai; Meng, Zhaowei; Fan, Yaguang

doi:10.2217/bmm-2019-0432

Cited by 14 publications

(19 citation statements)

References 36 publications

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“…Metastases were detected in 24% of patients with TgAb elevation (Rosario et al 2016). Using that comparison (TgAb before and after ablation with 131 I), patients without significant TgAb reduction exhibit a higher risk of tumor persistence/recurrence than those with a reduction > 50% (Kim et al 2008, Rosario et al 2016, Ernaga-Lorea et al 2018, Trimboli et al 2017, Sun et al 2020. In fact, instead of grouping patients with declining and stable TgAb (Haugen et al 2015, Lamartina et al 2018, Filetti et al 2019, other authors consider that TgAb stability deserves greater attention than a significant reduction (Verburg et al 2013, Haddad et al 2020.…”

Section: Initial Assessmentmentioning

confidence: 99%

“…We consider periodic repetition of neck US appropriate in the case of persistence of TgAb and an excellent response to therapy, therefore, cannot be characterized. Significant TgAb elevation is associated with a higher risk of structural disease and requires extended investigation if neck US does not reveal tumor recurrence (Kim et al 2008, Hsieh & Wang 2014, Rosario et al 2016, Ernaga-Lorea et al 2018, Trimboli et al 2017, Lee et al 2020, Sun et al 2020. However, before this investigation with other imaging methods, it would be interesting to confirm the persistence of TgAb elevation, which would only be considered significant if the increase in concentrations is higher than 50%.…”

Section: Initial Risk Stratificationmentioning

confidence: 99%

“…However, before this investigation with other imaging methods, it would be interesting to confirm the persistence of TgAb elevation, which would only be considered significant if the increase in concentrations is higher than 50%. On the other hand, patients with negative serum Tg-IMA and neck US without abnormalities but a reduction > 50% in TgAb concentrations are at a low risk of structural disease (Kim et al 2008, Hsieh & Wang 2014, Rosario et al 2016, Ernaga-Lorea et al 2018, Trimboli et al 2017, Lee et al 2020, Sun et al 2020 and do not require additional investigation. Finally, the risk of structural disease appears to be higher in patients with a modest reduction or long-term stability of TgAb concentrations compared to those exhibiting a significant reduction (Kim et al 2008, Hsieh & Wang 2014, Rosario et al 2016, Ernaga-Lorea et al 2018, Trimboli et al 2017, Sun et al 2020.…”

Section: Initial Risk Stratificationmentioning

confidence: 99%

“…On the other hand, patients with negative serum Tg-IMA and neck US without abnormalities but a reduction > 50% in TgAb concentrations are at a low risk of structural disease (Kim et al 2008, Hsieh & Wang 2014, Rosario et al 2016, Ernaga-Lorea et al 2018, Trimboli et al 2017, Lee et al 2020, Sun et al 2020 and do not require additional investigation. Finally, the risk of structural disease appears to be higher in patients with a modest reduction or long-term stability of TgAb concentrations compared to those exhibiting a significant reduction (Kim et al 2008, Hsieh & Wang 2014, Rosario et al 2016, Ernaga-Lorea et al 2018, Trimboli et al 2017, Sun et al 2020. Also regarding the late follow-up, not all authors group patients with declining and stable TgAb (Haugen et al 2015, Lamartina et al 2018, Filetti et al 2019, considering that TgAb stability is a matter of greater concern in terms of the risk of tumor recurrence (Verburg et al 2013, Haddad et al 2020.…”

Section: Initial Risk Stratificationmentioning

confidence: 99%

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Follow-up of patients with thyroid cancer and antithyroglobulin antibodies: a review for clinicians

Rosário

Côrtes

Mourão

2021

Endocrine-Related Cancer

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Antithyroglobulin antibodies (TgAb) are present in up to 25% of patients with differentiated thyroid carcinoma on initial postoperative assessment. Detectable concentrations of TgAb even below the manufacturer’s cut-off can interfere with serum thyroglobulin (Tg) determination. When Tg is quantified using an immunometric assay (IMA) (hereafter referred to as Tg-IMA), this interference results in underestimated values of Tg. Although promising, more clinical trials evaluating the capacity of liquid chromatography/tandem mass spectrometry and of new assays to detect elevated Tg in patients with TgAb and structural disease are necessary, particularly when Tg is undetectable by a second-generation IMA (Tg-2GIMA). Neck ultrasonography (US) should be performed in patients submitted to total thyroidectomy and with negative Tg-IMA but with detectable TgAb more than 6 months after initial therapy. In patients treated with 131I, comparison of TgAb concentrations obtained before this treatment is useful to estimate the risk of disease and to guide the investigation. If initial assessment does not reveal any persistent tumor, repetition of US is recommended while TgAb persist. Significant elevation of TgAb requires extended investigation. On the other hand, patients with negative Tg-IMA and US without abnormalities who exhibit a reduction > 50% in TgAb generally do not require investigation. Although TgAb can interfere with Tg, the management and follow-up of patients submitted to total thyroidectomy with borderline TgAb can probably be the same as those recommended for patients without TgAb if Tg-2GIMA and US indicate an excellent response to therapy. Currently, the presence/absence or the trend of TgAb levels cannot be considered in the follow-up of patients submitted to lobectomy.

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Section: Initial Assessmentmentioning

confidence: 99%

Section: Initial Risk Stratificationmentioning

confidence: 99%

Section: Initial Risk Stratificationmentioning

confidence: 99%

Section: Initial Risk Stratificationmentioning

confidence: 99%

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Follow-up of patients with thyroid cancer and antithyroglobulin antibodies: a review for clinicians

Rosário

Côrtes

Mourão

2021

Endocrine-Related Cancer

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“…The prognostic role of TgAb has been studied in some studies ( 11 , 12 , 15 , 25 ). Although the studies differed in patient grouping, the authors found that the trend and reduction of TgAb > 50% are critical prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

Antithyroglobulin Antibody Variation During Follow-Up Has a Good Prognostic Value for Preoperative Antithyroglobulin Antibody-Positive Differentiated Thyroid Cancer Patients: A Retrospective Study in Southwest China

Liu

Yin

2021

Front. Endocrinol.

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ObjectiveAntithyroglobulin antibody (TgAb) is a potential tumour marker for detecting differentiated thyroid cancer (DTC) recurrence, but insufficient data have supported its clinical applications. Our study aimed to describe the changing trend of TgAb after surgery and identify the relationship between this trend and clinical outcomes.Patients and MethodsWe reviewed the electronic records of 1,686 DTC patients who had undergone total thyroidectomy (TT) and radioactive iodine (131I) therapy at West China Hospital of Sichuan University from January 2015 to December 2017. Finally, 289 preoperative TgAb-positive DTC patients were included and divided into four subgroups depending on the clinical outcome: Group A (tumour free), Group B (uncertain), Group C (incomplete biochemical response), and Group D (structural disease). The patient demographics, tumour characteristics, operations, pathology reports, and all serological biomarkers were reviewed and compared, and the prognostic efficacy of TgAb was evaluated.ResultsAmong all 1,686 patients, 393 (23.65%) were TgAb positive (>40 IU/ml) preoperatively. The TgAb level in Group A decreased significantly after surgery and 131I therapy and stabilised at a low level after 1–2 years of 131I therapy. However, in the other three groups, the decrease in TgAb was not significant after treatment. Conversely, TgAb declined slowly and remained stable or increased. The variations in TgAb relative to the preoperative level of Group A were significantly larger than those of Groups B, C, and D at most time points of follow-up (p < 0.001). By receiver operating characteristic (ROC) analyses, the variations of TgAb > −77.9% at 6 months after 131I therapy (area under the curve (AUC) = 0.862; p < 0.001) and TgAb > −88.6% at 2 years after 131I therapy (AUC = 0.901; p < 0.001) had good prognostic efficacy in tumour-free survival. When the variation in TgAb > −88.6% at 2 years after 131I therapy was incorporated as a variable in the American Thyroid Association (ATA) categories, both intermediate- and high-risk patients also had a significantly increased chance of being tumour free (from 75.68% to 93.88% and 42.0% to 82.61%, respectively).ConclusionsFor preoperative TgAb-positive DTC patients, variations in TgAb > −77.9% at 6 months after 131I therapy and TgAb > −88.6% at 2 years after 131I therapy had good prognostic efficacy. Their incorporation as variables in the ATA risk stratification system could more accurately predict disease-free survival.

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Thyroglobulin antibodies: Trend over time and clinical impact in differentiated thyroid carcinoma with and without radioiodine ablation

Iglesias¹,

Calabretta²,

Coggiola³

et al. 2022

Endocrinología, Diabetes y Nutrición (English ed.)

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Prognostic Value and Dynamics of Antithyroglobulin Antibodies for Differentiated Thyroid Carcinoma

Cited by 14 publications

References 36 publications

Follow-up of patients with thyroid cancer and antithyroglobulin antibodies: a review for clinicians

Follow-up of patients with thyroid cancer and antithyroglobulin antibodies: a review for clinicians

Antithyroglobulin Antibody Variation During Follow-Up Has a Good Prognostic Value for Preoperative Antithyroglobulin Antibody-Positive Differentiated Thyroid Cancer Patients: A Retrospective Study in Southwest China

Thyroglobulin antibodies: Trend over time and clinical impact in differentiated thyroid carcinoma with and without radioiodine ablation

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