The Influences of TSH Stimulation Level, Stimulated Tg Level and Tg/TSH Ratio on the Therapeutic Effect of 131I Treatment in DTC Patients

Abstract

PurposeTo study the influences of pre-ablation TSH stimulation level, sTg and sTg/TSH ratio on the therapeutic effect of the first 131I treatment in DTCs.MethodsAccording to the thyroid stimulating hormone (TSH) levels (mU/l), all the 479 differentiated thyroid cancer (DTC) patients were divided into two groups: TSH < 30 and TSH ≥ 30. The TSH ≥ 30 group was divided into three subgroups: 30 ≤ TSH < 60, 60 ≤ TSH < 90 and TSH ≥ 90. The clinical features and the therapeutic effects of the first 131I treatment were analyzed. The cutoffs of stimulated thyroglobulin (sTg) and sTg/TSH ratio were calculated to predict the therapeutic effect of 131I treatment.ResultsAmong the three subgroups, the TSH ≥ 90 subgroup was younger and less likely to be associated with cervical lymph node metastasis (LNM). The postoperative levothyroxine (L-T4) dose in the 60 ≤ TSH < 90 subgroup was the lowest. Between the two groups, patients in the TSH < 30 group had higher postoperative L-T4 dose and longer thyroid hormone withdrawal (THW) time. The excellent response rates six months after the first 131I treatment among the three subgroups and between the two groups were not of statistical significance. The distribution of different TSH stimulation levels among each response group was similar. The cutoffs for the better therapeutic effect of the first 131I treatment in sTg and sTg/TSH were < 9.51 ng/ml and < 0.11, respectively. Both univariate and multivariate logistic regressions showed that cervical LNM, distant metastasis, higher sTg and higher sTg/TSH ratio predicted poorer therapeutic effect.ConclusionsThere was no significant influence of TSH stimulation levels before the first 131I treatment on the therapeutic effect of DTC. The sTg/TSH ratio can be considered as another predictor of 131I therapeutic effect.

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

“…In this study, we found that patients with higher sTg levels were more likely to have non-ER. sTg critical value for predicting non-ER was 4.7 µg/L, with an area under the curve of 0.922, a sensitivity of 90.38%, and a speci city of 81.16%, which was close to the previously reported data [27][28][29][30]. However, sTg may be more accurate when corrected by TSH, because Tg levels are signi cantly affected by thyrotropic stimulation of TSH on the thyroid remnant [5].…”

“…A retrospective study revealed that patients with sTg > 18 ng/ml and sTg/TSH > 0.35 before RAI therapy were signi cantly associated with unsuccessful ablation [31]. Another study indicated that the sTg < 9.51 ng/ml and sTg/TSH < 0.11 predicted a better therapeutic outcome [30]. In this study, we found that, like sTg, the sTg/TSH ratio was strongly correlated with the therapeutic response.…”

Analysis of factors influencing the clinical outcome after surgery and 131I therapy in patients with moderate-risk thyroid papillary carcinoma

“…A retrospective analysis revealed that the ps-Tg level <8.55 ug/L before ablation predicted 88% sensitivity and 72% specificity for disease remission following 18-24 months of 131 I therapy (18). Zheng et al (19) demonstrated that the ps-Tg level <9.51 ug/L indicated better efficacy of 131 I treatment in patients with DTC. The present study found that a cut-off value of 6.915 ug/L predicted ER, which is similar to the results of the abovementioned past studies.…”

Stimulated Thyroglobulin and Pre-ablation Antithyroglobulin Antibody Product Can Predict the Response to Radioiodine Therapy in TgAb-positive Differentiated Thyroid Cancer Pa-tients: A Retrospective Study

“…Surgery, selective radioiodine therapy (RAIT) after total thyroidectomy (TT) and thyroid stimulating hormone (TSH) sup-pressive therapy are the standard treatments for DTC [1]. As a speci c tumor marker for long-term follow-up after RAIT in DTC, serum thyroglobulin (Tg) can predict DTC persistence, distant metastasis or recurrence [2,3,4]. However, the Tg level can be affected by antithyroglobulin antibody (TgAb), which made Tg measurement becomes unreliable.…”