Additional value of a high sensitive thyroglobulin assay in the follow-up of patients with differentiated thyroid carcinoma

Clin Endocrinol (Oxf). 2017 Mar;86(3):419-424. doi: 10.1111/cen.13180. Epub 2016 Sep 28.

Abstract

Objective: Thyroglobulin (Tg) is an excellent tumour marker, as detectable or increasing Tg levels are highly indicative of persistent or recurrent differentiated thyroid carcinoma (DTC). The clinical value of a highly sensitive (hs)-Tg assay in patients with DTC has not yet been established. The aim of this study was to investigate the additional value of unstimulated hs-Tg measurements (Tg-on) compared to stimulated IRMA-Tg measurements (Tg-off) in the follow-up of patients with DTC.

Design, patients, measurements: We retrospectively studied patients treated for DTC between 2006 and 2013 and compared hs-Tg and IRMA-Tg measurements. The study group consisted of 99 DTC patients in remission; Tg-on was measured 3 months after remnant ablation and Tg-off 6 months after ablation.

Results: In the study group, 44 patients showed a hs-Tg-on <0·15 μg/l (functional sensitivity); of these, 43 had an IRMA-Tg-off measurement <1·0 μg/l, resulting in a negative predictive value of 97·7% and a positive predictive value of 56·4%.

Conclusions: The hs-Tg-on measurement is able to predict patients with an IRMA-Tg-off <1·0 μg/l, and therefore decreases the need for Tg stimulation after ablation.

MeSH terms

  • Adult
  • Biomarkers, Tumor / blood
  • Biomarkers, Tumor / standards
  • Catheter Ablation
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Period
  • Predictive Value of Tests
  • Remission Induction
  • Retrospective Studies
  • Thyroglobulin / blood*
  • Thyroid Function Tests / methods
  • Thyroid Function Tests / standards
  • Thyroid Neoplasms / diagnosis*

Substances

  • Biomarkers, Tumor
  • Thyroglobulin