Thyroid autoantibodies in thyroid cancer: Incidence and relationship with tumour outcome

Abstract

In the present investigation we studied serum anti-thyroglobulin and anti-thyroid microsomal autoantibodies, measured by hemagglutination technique, in 600 patients with thyroid cancer seen by us from 1975 to 1985 (mean follow-up 46 months). Positive thyroglobulin antibodies and/or microsomal antibodies were found in 138 (23%) patients (23.9% with papillary, 25% with follicular, 16.1% with anaplastic, and 4.1% with medullary thyroid carcinomas). The incidence of positive tests was similar in each decade of life (ranging between 21.9% and 27.9%), whereas in a normal sex-matched population with no evidence of thyroid disease, the frequency of positive tests was very low in young people and increased to 23% in people older than 60. In 64 patients with no evidence of residual or metastasic thyroid tissue after surgery and radioiodine, initially positive antibody titres became negative in 54.6%, decreased in 32.8%, did not change in 3.1%, and increased in 9.3%. On the contrary, antibody titres of patients with persistent disease became undetectable in 8.3%, decreased in 16.6%, remained unchanged in 25%, and increased in 50%. The clinical course of differentiated thyroid cancer was unaffected by the presence of thyroid antibodies and no difference was found in the death rate between antibody-positive and antibody-negative patients (11.5% and 13.6%, respectively). In conclusion, our data indicate that: 1) autoimmune phenomena are not an infrequent finding in thyroid cancer; 2) as in non-malignant thyroid diseases, positive-antibody tests are more frequently observed in females than in males; 3) at variance with normal controls, no age-dependent increase in serum anti-thyroid antibodies was found in thyroid cancer; 4) the presence of metastatic thyroid tissue seems to be necessary to perpetuate the autoantibody synthesis, and 5) anti-thyroid autoantibodies are not a protective or worsening factor in the tumour outcome.The relationship between thyroid autoimmunity and thyroid cancer is still unclear. No evidence of increased incidence of antithyroid-microsomal autoantibodies was found by Kornstad (1974) in a large series of thyroid cancer patients using the complement fixation technique. In a few similar studies using the more sensitive passive hemagglutination method, a significant increase in the incidence of anti-thyroglobulin and microsomal autoantibodies has been reported in thyroid ma¬ lignancies, with positivity ranging from 2.3 to 15% for thyroglobulin antibodies and from 9.1 to 21% for microsomal antibodies (Kornstad 1974;Amino et al. 1975;DeGroot et al. 1976;Pinchera et al. 1977;Mariotti et al. 1978). The main limita¬ tion of most of the above investigations was the rather small number of patients studied and the lack of adequate follow-up.In this study we re-evaluated the incidence of thyroglobulin antibodies and microsomal anti¬ bodies in a large series of patients with thyroid cancer. We also correlated the behaviour of serum antibodies with several clinical parameters and with the tumour outcome.

Development and clinical impact of thyroglobulin antibodies in patients with differentiated thyroid carcinoma during the first 3 years after thyroidectomy

“…The use of TgAbs as a prognostic parameter in DTC remains controversial. While Rubello et al (18) and Adil et al (12) reported a higher frequency of relapse in association with persisting TgAbs after ablative therapy, the majority of authors (1,8,10,11) found no correlation, in agreement with our data. …”

Thyroglobulin Liquid Chromatography–Tandem Mass Spectrometry Has a Low Sensitivity for Detecting Structural Disease in Patients with Antithyroglobulin Antibodies

“…A ntithyroglobulin antibodies (anti-TgAbs) are detectable in about 20-25% of patients with thyroid cancer (TC) (1,2). These antibodies interfere with measurement of thyroglobulin (Tg), the key biomarker used to detect and monitor thyroid cancer (2).…”

“…These antibodies interfere with measurement of thyroglobulin (Tg), the key biomarker used to detect and monitor thyroid cancer (2). Tg is generally measured using immunometric assays (IMA) or radioimmunoassay (RIA), with the former being more commonly used in the United States.…”

Novel Approaches to the Management of Graves` Ophthalmopathy

“…The concept that total thyroid ablation reduces thyroid autoimmune phenomena is supported by the observation that total thyroidectomy followed by radioiodine therapy is associated with a progressive decrease and disappearance of circulating autoantibodies in initially antibody-positive thyroid cancer patients who are diseasefree after treatment 87 . Therefore, also in the case of GO, total antigen deprivation and autoreactive T-lymphocyte depletion might prove beneficial for eye disease 88 .…”