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JOURNAL ARTICLE

Predictive value of preablation stimulated thyroglobulin and thyroglobulin/thyroid-stimulating hormone ratio in differentiated thyroid cancer

Yansong Lin, Tianjun Li, Jun Liang, Xiaoyi Li, Liheng Qiu, Shasha Wang, Yonghui Chen, Zengshou Kang, Fang Li
Clinical Nuclear Medicine 2011, 36 (12): 1102-5
22064080

PURPOSE: Recent studies have shown that thyroglobulin (Tg) concentration is a useful tumor marker in follow-up of differentiated thyroid cancer (DTC) patients after thyroidectomy and subsequent radioiodine (I-131) therapy. However, its role is controversial after total or near-total thyroidectomy before the first I-131 ablative treatment. So, we used thyroid-stimulating hormone (TSH) levels to normalize predictive values of Tg for DTC.

METHODS: The study was a retrospective analysis. A total of 244 patients with DTC who had undergone a total thyroidectomy and subsequent I-131 therapy were included. Exclusion criteria were patients with high serum Tg antibody (TgAb) concentration and in whom it was not measured. Patients were divided into 2 groups as M1 and M0, according to whether the patient present with or without distant metastases.

RESULTS: Preablative stimulated Tg in group M0 ranged between 0.1 and 348.9 ng/mL and group M1 between 0.2 and 1000 ng/mL. Tg/TSH ratios ranged 0.000667 to 12.143 ng/IU and 0.002948 to 12500 ng/IU. Both Tg and Tg/TSH values were significantly different between the 2 groups (the Wilcoxon rank sum test: Tg P < 0.0001 [z = 8.785]; Tg/TSH P < 0.0001 [z = 8.850]). The areas under receiver operating characteristic curves for Tg concentrations and Tg/TSH ratios were 0.913 and 0.916, respectively.

CONCLUSION: Both Tg and Tg/TSH ratios might be considered predictive markers for metastases of DTC just after total thyroidectomy before the first I-131 ablative therapy.

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