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83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

16.05. - 20.05.2012, Mainz

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Elevated serum thyroglobulin as a risk factor of recurrent differentiated thyroid carcinoma after thyroid ablation

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  • corresponding author Jasminka Alagic-Smailbegovic - ENT Clinic Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
  • Ilhana Setic - ENT Clinic, Sarajevo, Bosnia and Herzegovina
  • Kamenko Sutalo - ENT Clinic, Sarajevo, Bosnia and Herzegovina
  • Mersiha Becirovic - ENT Clinic, Sarajevo, Bosnia and Herzegovina
  • Rusmir Arslanagic - ENT Clinic, Sarajevo, Bosnia and Herzegovina

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 83. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Mainz, 16.-20.05.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12hnod191

doi: 10.3205/12hnod191, urn:nbn:de:0183-12hnod1911

Published: April 4, 2012

© 2012 Alagic-Smailbegovic et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: Initial management of differentiated thyroid cancer (DTC) is surgical, followed by radioiodine 131I ablation and by the long term administration of thyroid hormon. Recurrent disease does occur in approximately 20–40% of patients. Guidelines for the follow-up management of DTC are commonly based on circulating thyrogobulin measurement in the complete absence of eutopic thyroid tissue.

AIM: to assess the prognostic value of thyroglobulin in patients with DTC after thyroid ablation.

Materials and methods: A retrospective study included 116 patients (66 papillary and 50 follicular carcinoma, mean age 51.2 years) who had undergone thyroidectomy and radioactive iodine remnant ablation. Stimulated serum thyroglobulin (Tg) and anti-thyroglobulin antibodies (TgAb) levels were measured 6 and 12 months after ablation therapy (Tg1, TgAb1 and Tg2, TgAb2,b respectively).

Results: During one year of follow-up, in a total of 24 patients (21%) recurrent disease were confirmed. Patients with recurrent disease significantly had levels of Tg1 and Tg2 above threshold (>10ng/ml), since patients with no evidence of disease significantly had low levels of Tg1 and Tg2. A Chi-square test for independence indicated significant association between higher values of Tg1 and recidives of cancer (p<0.0001), and Tg2 and recidives of cancer (p<0.0001).

Conclusions: Although presurgical serum Tg is no specific for DTC and could not have significant prognostic value, serum Tg level after surgery is an excellent biological marker of persistent or recurrent DTC. Periodicaly measurements of Tg and TgAb in the postoperative period and after ablative therapy have a predictive value, because stimulated Tg levels above 10 ng/ml confirmed that indicate residual or recurrent cancer.