Prognostic Significance of Thyroglobulin Antibody Epitopes in Differentiated Thyroid Cancer
| Autor: | John Lazarus, Lakdassa D. K. E. Premawardhana, C. Evans, A. J. Pickett, P. M. Clark, Onyebuchi E. Okosieme, Giovanni Lupoli, Gelsy Arianna Lupoli |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Endocrinology Diabetes and Metabolism medicine.medical_treatment Clinical Biochemistry Context (language use) Hashimoto Disease Monoclonal antibody Thyroglobulin Biochemistry Thyroiditis Epitope Epitopes Young Adult Endocrinology Antibody Specificity Internal medicine medicine Humans Thyroid Neoplasms Thyroid cancer Aged Autoantibodies Aged 80 and over Immunoradiometric assay business.industry Biochemistry (medical) Thyroid Middle Aged Prognosis medicine.disease Adenocarcinoma Papillary medicine.anatomical_structure Female business Follow-Up Studies |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 100:100-108 |
| ISSN: | 1945-7197 0021-972X |
| Popis: | Context: Thyroglobulin antibodies (TgAbs) are surrogate markers of disease recurrence or persistence in differentiated thyroid cancer (DTC). However, the prognostic significance of TgAb heterogeneity in DTC has not been investigated. Objective: To evaluate the relationship between TgAb epitope specificities and clinical outcomes in DTC patients. Design: We studied 61 TgAb-positive patients with DTC, post-thyroidectomy and remnant ablation (7 males, 54 females; age-range 16–80 years, median follow-up duration 8.9 years). TgAb epitope reactivities were mapped using a panel of 10 thyroglobulin (Tg) monoclonal antibodies delineating six antigenic Tg clusters in competitive ELISA studies. Sera from 45 patients with Hashimoto's thyroiditis (HT) and 22 TgAb-positive healthy subjects served as autoimmune and healthy controls. Tg was measured by immunoradiometric assay (IRMA), electrochemiluminescence immunoassay (ECLIA), and RIA, while TgAbs was measured by ELISA and ECLIA methods. Results: Samples from 26 DTC patients showed TgAb epitope restriction similar to HT patients, while 35 patients exhibited nonspecific reactivity comparable to healthy controls. DTC patients with epitope restriction had higher rates of recurrent/persistent disease (81% vs 17%, P < .001), higher median TgAb concentration (887.0 vs 82.0 kIU/L; P < .001), and a higher prevalence of thyroid lymphocytic infiltration (71.4% vs 26.8%; P < .001) compared to patients with nonspecific reactivity. Samples with epitope restriction also had a lower median Tg-IRMA/RIA ratio (3.0% vs 36.0%; P < .001) denoting greater degrees of Tg assay interference. Conclusions: TgAb epitope restriction is associated with a less favorable prognosis than nonspecific reactivity in DTC patients. TgAb epitope specificities may have prognostic value in DTC |
| Databáze: | OpenAIRE |
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