Thyroglobulin assay 4 weeks after thyroidectomy predicts outcome in low-risk papillary thyroid carcinoma
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Luca Giovanella
Abstract
Background: Thyroidectomy followed by administration of large activities of 131I is the treatment of choice for differentiated thyroid carcinomas. Due to its good prognosis, some authors argue that papillary thyroid cancer with a diameter of up to 10mm can be treated by surgery alone. In the new TNM classification started in 2002, the T1 group now encompasses all tumours with a diameter up to 20mm, which widens the indications for a conservative approach. In this instance, prognostic markers are needed to better select patients before planning non-aggressive treatment. Serum thyroglobulin plays a pivotal role in thyroid carcinoma management after thyroid ablation (i.e., surgery and radioiodine) but is of limited value before these treatments. However, thyroglobulin assay performed after surgery but before radioiodine treatment has been proven to be useful in predicting the presence/absence of distant metastasis. Patients and methods: Our study was undertaken in patients affected by pT1 papillary thyroid carcinoma to evaluate the predictive value of post-surgery thyroglobulin assay on 1) restaging immediately after radioiodine treatment and 2) restaging at 12months. We selected 156 patients affected by pT1 histologically proven papillary thyroid carcinoma, submitted to total thyroidectomy. Serum thyroglobulin was assayed by a specific immunoradiometric method 4weeks after surgery, just before radioiodine administration. Cut-off levels were selected by receiver operating characteristic curve analysis. Thyroglobulin levels were compared to the results of a post-radioiodine treatment scan and 12-month restaging. Results: Globally, 23 out of 156 patients showed persistent/recurrent disease (15%). Post-surgery thyroglobulin levels above 4.50μg/L identified 94% of patients with metastasis at post-dose scan, and a level below 3.20μg/L identified 86% and 93% of relapsed and disease-free patients at 12-month restaging, respectively. Multivariate analysis and Spearman rank correlation showed that the N-status and post-surgery thyroglobulin level are independent prognostic factors. Conclusions: The post-surgery thyroglobulin level could be systematically assayed in patients with pT1-papillary thyroid carcinoma and taken into account in planning treatment.
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©2005 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Familial hypercholesterolemia and response to statin therapy according to LDLR genetic background
- Detection of brain injury by fatty acid-binding proteins
- High-throughput scanning of breast tumor surgical specimens for low-level mutations
- Cardiovascular risk-associated allele frequencies for 15 genes in healthy elderly French and Chinese
- Soluble CD30 serum levels before and after treatment with α-interferon in patients with chronic hepatitis C
- Development, validation and evaluation of a homogenous one-step reverse transcriptase-initiated PCR assay with competitive internal control for the detection of hepatitis C virus RNA
- Counteracting adriamycin-induced oxidative stress by administration of N-acetyl cysteine and vitamin E
- Comparative analysis of the DNA staining efficiencies of different fluorescent dyes in preparative agarose gel electrophoresis
- Thyroglobulin assay 4 weeks after thyroidectomy predicts outcome in low-risk papillary thyroid carcinoma
- Measurement of troponin I 48h after admission as a tool to rule out impaired left ventricular function in patients with a first myocardial infarction
- The efficacy of cystatin C assay in the prediction of glomerular filtration rate. Is it a more reliable marker for renal failure?
- Reference materials (RMs) for analysis of the human factor II (prothrombin) gene G20210A mutation
- Influence of short-term venous stasis on clinical chemistry testing
- Educational intervention together with an on-line quality control program achieve recommended analytical goals for bedside blood glucose monitoring in a 1200-bed university hospital
- The reliability of calculated laboratory results
- Preliminary evaluation of the performance of a new, highly sensitive commercial immunoassay for serum ferritin determination
- Importance of the detection method for intact dimeric human chorionic gonadotropin without interference with the free human chorionic gonadotropin β subunit for pregnancy exclusion before liver transplantation in a woman with cholangiocarcinoma
- Comparison of Liaison N-tact PTH (Diasorin) and N-tact PTH SP IRMA (Diasorin) in hemodialyzed patients
