Basal Serum Thyroglobulin Measured by a Second-Generation Assay Is Equivalent to Stimulated Thyroglobulin in Identifying Metastases in Patients with Differentiated Thyroid Cancer with Low or Intermediate Risk of Recurrence
| Autor: | Maria C.O.M. Mamone, Cleber P. Camacho, Jairo Tabacow Hidal, Rui M. B. Maciel, Rosalia P. Padovani, José Gilberto H. Vieira, Flávia C. Aldighieri, Danielle M. Andreoni, Elza S. Ikejiri, Claudia A. Yamazaki, Felipe Crispim, Teresa S. Kasamatsu, Rosa Paula M. Biscolla, Cláudia C. D. Nakabashi, Jairo Wagner |
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| Rok vydání: | 2014 |
| Předmět: |
endocrine system
medicine.medical_specialty Clinical Thyroidology / Original Paper endocrine system diseases business.industry Endocrinology Diabetes and Metabolism medicine.medical_treatment medicine.disease Serum thyroglobulin Basal (phylogenetics) Text mining Endocrinology Internal medicine medicine In patient Thyroglobulin Intermediate risk business Thyroid cancer hormones hormone substitutes and hormone antagonists |
| Zdroj: | European Thyroid Journal. 3:43-50 |
| ISSN: | 2235-0802 2235-0640 |
| DOI: | 10.1159/000360077 |
| Popis: | Guidelines for the follow-up of differentiated thyroid cancer (DTC) recommend the measurement of TSH-stimulated thyroglobulin (s-Tg) instead of basal Tg on T4 therapy (b-Tg). However, these guidelines were established using first-generation Tg assays with a functional sensitivity (FS) of 0.5-1.0 ng/ml. Current more sensitive second-generation Tg assays (Tg2G; FS 0.05-0.10 ng/ml) have shown that low-risk DTC patients with undetectable b-Tg rarely have recurrences.This study was undertaken to compare b-Tg using a chemiluminescent Tg2G assay (Tg2GICMA; FS 0.1 ng/ml) with s-Tg in DTC patients with an intermediate risk of recurrence.We evaluated 168 DTC patients with a low (n = 101) and intermediate (n = 67) risk of recurrence treated by total thyroidectomy (147 also treated with radioiodine), with a mean follow-up of 5 years.b-Tg was undetectable with the Tg2GICMA in 142 of 168 patients. s-Tg was2 ng/ml in 138 of these 142 patients, and only 3 of these 138 (2%) presented metastases on cervical ultrasound (US). Of the 4 of 142 patients with s-Tg2 ng/ml, 1 had cervical metastases seen after radioiodine. Furthermore, 26 of 168 patients presented detectable b-Tg with the Tg2GICMA; 17 of these 26 patients also presented s-Tg2 ng/ml. In 10 of these 17 patients, metastases were detected. Cervical US or b-Tg were positive in 14 of 15 patients with recurrent disease. Globally, the sensitivity and negative predictive value of the Tg2GICMA plus US were 93 and 99%, respectively.b-Tg measured with a Tg2GICMA and cervical US, used together, are equivalent to s-Tg in identifying metastases in patients with DTC with a low or intermediate risk of recurrence. |
| Databáze: | OpenAIRE |
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