Thyroglobulin Antibody Is Associated with Increased Cancer Risk in Thyroid Nodules

Kim, Eun Sook; Lim, Dong Jun; Baek, Ki Hyun; Lee, Jong Min; Kim, Mee Kyoung; Kwon, Hyuk Sang; Song, Ki Ho; Kang, Moo Ii; Yun, Bong; Lee, Kwang Woo; Son, Ho Young

doi:10.1089/thy.2009.0384

Cited by 160 publications

(154 citation statements)

References 44 publications

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“…Lindsay et al (1955) first described an association of AIT and papillary thyroid carcinoma [8]. Several groups found a high incidence of AIT in papillary thyroid carcinoma up to 44 % [9,10]. Data of our group show an incidence of 21 % of AIT in thyroid carcinoma patients (Bouter et al, unpublished data).…”

supporting

confidence: 50%

What makes Lymphadenopathy in Patients with Autoimmune Thyroiditis Suspicious for Malignancy?

Bouter¹,

Meller²,

Meller³

et al. 2016

Exp Clin Endocrinol Diabetes Rep

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Lymphadenopathy in Robbins level II-IV and VI is common in autoimmune thyroiditis but the diagnostic strategy of a distinct lymphadenopathy exceeding the known features in autoimmune thyroiditis patients is unknown. The aim of this study was to determine how the extent of cervical lymphadenopathy in autoimmune thyroiditis affects the diagnostic management.The study comprises one index-patient with autoimmune thyroiditis and distinct suspicious lymphadenopathy in all cervical levels as well as retroclavicular. In addition 10 patients with autoimmune thyroiditis and distinct suspicious lymphadenopathy limited to level VI were evaluated.Findings of high resolution ultrasound, fine-needle aspiration cytology, serological testing and clonal analysis are reported here. Further diagnostics of the index-patient included histology, immunohistochemistry, bcl-2-expression analysis and PET/CT.The index-patient showed distinct lymphadenopathy in level I-VI and retroclavicular. Lymph nodes did not display any sonographic malignancy criteria. Molecular analysis and immunohistochemistry revealed monoclonal CD10- and CD20-positive, Bcl-2 expressing follicular B-cells confirming the diagnosis of a follicular B-cell Non-Hodgkin lymphoma.10 additional patients with limited lymphadenopathy showed typical features of autoimmune thyroiditis and lymph nodes did not display sonographic malignancy criteria in all cases. Further tests excluded lymph node malignancies.Extensive diagnostics in autoimmune thyroiditis and distinct cervical lymphadenopathy is crucial. Whereas limited lymphadenopathy in AIT was proven benign, extensive lymphadenopathy exceeding the known amount and/or spreading to retroclavicular/mediastinal compartments is suspicious for malignancy. Even in the absence of sonographic malignancy criteria further tests have to be performed.

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supporting

confidence: 50%

What makes Lymphadenopathy in Patients with Autoimmune Thyroiditis Suspicious for Malignancy?

Bouter¹,

Meller²,

Meller³

et al. 2016

Exp Clin Endocrinol Diabetes Rep

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“…In the aforementioned studies by Kim et al [11] and Grani et al [13], the patient's final diagnostic outcome was established following FNAC, with only a minority of diagnoses confirmed by histological follow-up. One limitation of using FNAC as a diagnostic tool is that the cytological features observed in the sample obtained are not necessarily representative of the entire thyroid tissue and cannot consequently offer a definitive diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Can Preoperative Thyroglobulin Antibody Levels Be Used as a Marker for Well‐Differentiated Thyroid Cancer?

Hosseini¹,

Zawawi²,

Varshney³

et al. 2014

Otolaryngol.--head neck surg.

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Background: It has been reported that thyroglobulin antibody are more frequently elevated in patients with thyroid cancercompared to general population. This study aims at evaluating whether preoperative thyroglobulin antibody (TgAb) levels increase the likelihood that a thyroid nodule is malignant. Methods: A retrospective review of 586 patients who underwent thyroidectomy was conducted. Demographic data, TgAb levels, and final histopathology were recorded. Patients were divided into two groups: TgAb positive (defined as TgAb ≥ 30 IU/ml) and TgAb low/negative (defined as TgAb < 30). Results: Preoperative TgAb levels were available in 405 patients. There were 353 (87 %) patients in the TgAblow/ negative group (malignancy rate: 50.42 %) and 52 (13 %) patients in the TgAb positive group (malignancy rate: 65.38 %). The sensitivity, specificity, positive predictive value and negative predictive value of TgAb ≥ 30 IU/ml for thyroid malignancy were 16.04 %, 90.67 %, 65.38 % and 49.58 %, respectively. The relative risk of having a malignant thyroid nodule when the TgAb titers were≥30 IU/ml was 1.30 (CI1.04-1.62) and the odds ratio was 1.86 (CI 1.01-3.41). Both the Pearson chi-square test (p = 0.024) and Fisher's exact test (p = 0.017) yielded statistical significance between the two groups. Conclusions: In this study, patients with preoperative TgAb ≥ 30 IU/ml had a higher rate of malignancy when compared topatients with TgAb < 30 IU/ml. This suggests that an elevated TgAb level may indicate that a thyroid nodule is at an increased risk for malignancy.

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“…When Positive serum Tg antibody (TgAb) is known to lower serum Tg (sTg) levels, and this may be even more important in DTC patients prior to thyroidectomy and/or radioactive iodine therapy in whom a higher rate of positive TgAb has been reported (17). Thus, the high rate of positive serum TgAb can lower sTg levels and influence FNA-Tg levels, which is possibly associated with altered diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody

Kim

Lim

et al. 2015

European Journal of Endocrinology

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Objective: Fine needle aspiration cytology (FNAC) and measurement of thyroglobulin (Tg) in needle washout (FNA-Tg) are recommended for the diagnosis of metastatic or recurrent lymph nodes (LNs) in differentiated thyroid cancer (DTC). However, the effect of serum Tg antibody (TgAb) on FNA-Tg levels still remains unclear in the preoperative setting. We analyze the interference of serum TgAb on FNA-Tg levels as proof of concept in the diagnostic advantage of serum TgAb combined with FNA-Tg. Subjects and methods: A total of 370 suspicious cervical LNs from 273 patients with DTC were included. The primary tumor was confirmed as DTC on preoperative pathology in all patients. We performed FNA-Tg measurement and FNAC on suspicious LNs and evaluated the diagnostic performance of FNAC and FNA-Tg according to TgAb status. Final diagnoses were confirmed by histological examination of excised specimens or by follow-up ultrasonography for at least 6 months. Results: Data from 273 subjects with suspicious 370 LNs were evaluated. Fifty-five LNs (14.9%) were from TgAbC positive serum TgAb (TgAbC) patients. Serum Tg and FNA-Tg levels were significantly lower in patients with TgAbC than in those with TgAb-negative (TgAbK). Final pathology confirmed 109 LNs (29.5%) asmalignant. Diagnostic performance of FNA-Tg at the same cutoff level was lower in the TgAbC than TgAbK group. FNA-Tg cutoff levels determined by ROC curve were lower in the TgAbC group. Conclusion: The results suggested that the cutoff value of FNA-Tg should be lowered in suspicious LN before thyroidectomy in thyroid cancer patients with TgAb.

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Thyroglobulin Antibody Is Associated with Increased Cancer Risk in Thyroid Nodules

Cited by 160 publications

References 44 publications

What makes Lymphadenopathy in Patients with Autoimmune Thyroiditis Suspicious for Malignancy?

What makes Lymphadenopathy in Patients with Autoimmune Thyroiditis Suspicious for Malignancy?

Can Preoperative Thyroglobulin Antibody Levels Be Used as a Marker for Well‐Differentiated Thyroid Cancer?

Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody

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