open access

Vol 66, No 6 (2015)
Original papers
Published online: 2015-12-07
Submitted: 2014-08-16
Accepted: 2015-03-10
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Comparison of the usefulness of post-ablative and post-operative thyroglobulin concentration measuring in prognostic assessment of patients with differentiated thyroid cancer

Klaudia Gadawska-Juszczyk, Aldona Kowalska
DOI: 10.5603/EP.a2015.0060
·
Endokrynologia Polska 2015;66(6):486-494.

open access

Vol 66, No 6 (2015)
Original papers
Published online: 2015-12-07
Submitted: 2014-08-16
Accepted: 2015-03-10

Abstract

Introduction: Post-operative thyroglobulin (TgPO) is a recognised prognostic factor in patients following thyroidectomy due to differentiated thyroid cancer (DTC). However, its concentration is affected by thyroid remnants, which may diminish the prognostic value of TgPO. The aim of this paper is to assess the usefulness of stimulated post-ablative thyroglobulin (TgPA) measurements 6–9 months after 131I therapy, as a prognostic factor, and its possible advantage over TgPO determination.

Material and methods: The study involved 577 DTC patients treated in the Holycross Cancer Centre in the years 2000–2013. Exclusion criteria were: patients with no recommendation for 131I adjuvant therapy, positive thyroglobulin antibody titre, and initial distant metastases. On the basis of a ROC curve analysis, values of TgPO and TgPA concentrations were determined, which enable the most accurate identification of good prognosis. Calculating area under the curves (AUCs) allowed for comparison of the data.

Results: TgPO concentration ≤ 6.99 ng/mL, with 75.7% sensitivity and 94.7% specificity enables anticipation of remission of the disease. TgPA concentration ≤ 1.16 ng/mL under endogenous TSH stimulation with sensitivity of 91.1% and specificity of 94.7% allows anticipation of remission of the disease. TgPA concentration ≤ 1.24 ng/mL under rh TSH stimulation with sensitivity of 95.4% and specificity of 95.0% enables anticipation of remission of the disease.

Conclusions: No differences in clinical usefulness of the assessment of TgPO and stimulated TgPA concentrations as indicators of good prognosis were found. However, TgPA allows anticipation of remission of the disease with higher sensitivity. It also appears that TgPA may be of particular prognostic importance in baseline high-risk patients (pT3-T4/N1). A sufficiently low TgPA concentration, demonstrating good response to 131I adjuvant therapy in these groups, is an indicator of improved prognosis. (Endokrynol Pol 2015; 66 (6): 486–494)

Abstract

Introduction: Post-operative thyroglobulin (TgPO) is a recognised prognostic factor in patients following thyroidectomy due to differentiated thyroid cancer (DTC). However, its concentration is affected by thyroid remnants, which may diminish the prognostic value of TgPO. The aim of this paper is to assess the usefulness of stimulated post-ablative thyroglobulin (TgPA) measurements 6–9 months after 131I therapy, as a prognostic factor, and its possible advantage over TgPO determination.

Material and methods: The study involved 577 DTC patients treated in the Holycross Cancer Centre in the years 2000–2013. Exclusion criteria were: patients with no recommendation for 131I adjuvant therapy, positive thyroglobulin antibody titre, and initial distant metastases. On the basis of a ROC curve analysis, values of TgPO and TgPA concentrations were determined, which enable the most accurate identification of good prognosis. Calculating area under the curves (AUCs) allowed for comparison of the data.

Results: TgPO concentration ≤ 6.99 ng/mL, with 75.7% sensitivity and 94.7% specificity enables anticipation of remission of the disease. TgPA concentration ≤ 1.16 ng/mL under endogenous TSH stimulation with sensitivity of 91.1% and specificity of 94.7% allows anticipation of remission of the disease. TgPA concentration ≤ 1.24 ng/mL under rh TSH stimulation with sensitivity of 95.4% and specificity of 95.0% enables anticipation of remission of the disease.

Conclusions: No differences in clinical usefulness of the assessment of TgPO and stimulated TgPA concentrations as indicators of good prognosis were found. However, TgPA allows anticipation of remission of the disease with higher sensitivity. It also appears that TgPA may be of particular prognostic importance in baseline high-risk patients (pT3-T4/N1). A sufficiently low TgPA concentration, demonstrating good response to 131I adjuvant therapy in these groups, is an indicator of improved prognosis. (Endokrynol Pol 2015; 66 (6): 486–494)

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Keywords

differentiated thyroid cancer; thyroglobulin; prognostic factors; disease remission

About this article
Title

Comparison of the usefulness of post-ablative and post-operative thyroglobulin concentration measuring in prognostic assessment of patients with differentiated thyroid cancer

Journal

Endokrynologia Polska

Issue

Vol 66, No 6 (2015)

Pages

486-494

Published online

2015-12-07

DOI

10.5603/EP.a2015.0060

Bibliographic record

Endokrynologia Polska 2015;66(6):486-494.

Keywords

differentiated thyroid cancer
thyroglobulin
prognostic factors
disease remission

Authors

Klaudia Gadawska-Juszczyk
Aldona Kowalska

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