Persistent or recurrent disease in thyroid cancer survivors who have elevated serum anti-thyroglobulin antibodies.

OBJECTIVE: Detection of residual differentiated thyroid cancer is important but difficult. A variety of imaging modalities and biochemical markers have been used with moderately good success. We hypothesized that elevated perioperative serum anti-thyroglobulin antibodies (TgAb) would also be a predictive marker for persistent or recurrent thyroid cancer.

METHODS: We performed a retrospective analysis of 277 differentiated thyroid cancer survivors divided into two groups: those with low or normal serum TgAb (TgAb-) and those with elevated serum TgAb (TgAb+). All patients were seen at one major academic medical center. Patients were followed for a median of 7.54 years.

RESULTS: Patients in the TgAb+ group were more likely to have positive lymph nodes at initial surgery, to be assigned to a higher AJCC Stage, and to have significantly higher incidence of persistent/recurrent disease. The higher incidence of persistent/recurrent cancer was significant under univariable and multivariable (including TgAb status, age, and sex) Cox proportional hazards model analysis.

CONCLUSION: We conclude that individuals with elevated serum TgAb at the outset should be followed with a higher index of suspicion for persistent/recurrent thyroid cancer.