The diagnostic and predictive accuracy of thyroglobulin to TSH ratio and TSH to thyroglobulin ratio in detecting differentiated thyroid carcinoma in normothyroid patients with thyroid nodules: A retrospective cohort study and systematic review of the literature
| Autor: | George-Marios Makris, Thomas D. Siamatras, Eva Kassi, Evangelos Karvounis, Anna Angelousi, Ioannis Kappas |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Thyroid nodules
Cancer Research medicine.medical_specialty endocrine system lcsh:Internal medicine endocrine system diseases medicine.medical_treatment 030209 endocrinology & metabolism thyroglobulin Gastroenterology Article Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine Thyroid-stimulating hormone systematic review Internal medicine medicine thyroid cancer Tg lcsh:RC31-1245 Thyroid cancer Predictive marker business.industry TSH Retrospective cohort study lcsh:Other systems of medicine medicine.disease lcsh:RZ201-999 Oncology 030220 oncology & carcinogenesis Thyroglobulin iodine therapy business Cohort study |
| Zdroj: | Oncology Reviews, Vol 14, Iss 2 (2021) Oncology Reviews |
| ISSN: | 1970-5565 1970-5557 |
| Popis: | The purpose of the present study is to examine the diagnostic and predictive accuracy of the thyroglobulin (Tg) to thyroid stimulating hormone (TSH) and TSH/Tg ratios in normothyroid patients with differentiated thyroid cancer (DTC). We conducted a retrospective cohort study evaluating the diagnostic accuracy of the serum Tg/TSH and TSH/Tg ratios in normothyroid patients with thyroid nodules. We also systematically searched the international literature using the Medline, Cochrane’s CENTRAL, Scopus, Clinicaltrials.gov, EMBASE, and Google Scholar databases for evidence concerning the diagnostic and predictive accuracy of these ratios. Overall, 374 patients were identified in our cohort study of whom 240 were treated for benign disease and 134 were treated for DTC. Significant differences were noted in the Tg/TSH and TSH/Tg values among cases with malignant and benign disease (P=0.020). However, the diagnostic ROC curve did not confirm these results (Tg/TSH=0.572 and TSH/Tg=0.428). After searching the international literature, we identified 8 studies. The majority of the included data reported significant differences among patients with benign/malignant disease and those with successful iodine therapy compared to those with disease relapse. However, the clinical relevance was clearer among studies that investigated the usefulness of these ratios in predicting recurrent disease. The findings of our study support that the Tg/TSH ratio increases in patients with DTC and can, thus, become useful in the future as a predictive marker of ablative 131I therapy success. However, given the significant variability of Tg its diagnostic accuracy remains to date minimal; thus, the actual cut-off value that can be used to discriminate cancer cases from benign disease has not been determined yet. |
| Databáze: | OpenAIRE |
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