Undetectable Serum Thyroglobulin in Patients With Differentiated Thyroid Cancer: Antithyroglobulin Antibodies, Assay Limitation, or Other?

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-06-09 DOI:10.1016/j.eprac.2025.06.001

Benjamin Andress, Sandra A Miller, Anthony D Maus, Jennifer V Kemp, Joshua A Bornhorst, Stefan K Grebe, Alicia Algeciras-Schimnich

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引用次数: 0

Abstract

Objective: To determine why some patients with differentiated thyroid cancer (DTC) lymph node (LN) metastases do not have detectable serum thyroglobulin (Tg).

Methods: Fine needle aspiration biopsy (FNAB) washout fluid from patients with DTC LN metastases and undetectable serum Tg measurement by immunoassay (Tg-IA) were evaluated for the presence of Tg and anti-Tg antibodies (TgAbs). Spike-recovery experiments in serum were performed to assess the reason for undetectable Tg.

Results: Of the 42 patients, 87% had detectable Tg in the FNAB washout fluid by Tg-IA, and 83% by Tg mass spectrometry (Tg-MS) measurement. Seventy-six percent of these patients had detectable serum TgAb, while 26% did not. Tg spike-recovery experiments performed on the TgAb+ (positive) serum samples showed decreased Tg recovery by Tg-IA but not by Tg-MS (Tg-IA mean, range: 50%, 12%-84%; Tg-MS 96%, 70%-117%). In TgAb- (negative) serum samples no interference was observed (>94% recoveries). No difference in FNAB washout fluid Tg recovery between TgAb- and TgAb+ patients was observed.

Conclusion: Tg was detected by both Tg-IA and Tg-MS methods in the majority of FNAB washout fluid from patients with DTC LN metastases who exhibited undetectable serum Tg by Tg-IA and Tg-MS. The absence of serum Tg could not be completely explained by the presence of TgAb. These results suggest that, for a subset of patients with DTC LN metastases, the absence of detectable Tg in serum does not appear to be due to analytical limitations of current Tg assays or the presence of TgAb interference.

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分化型甲状腺癌患者血清中检测不到甲状腺球蛋白：抗甲状腺球蛋白抗体、检测限制或其他？

目的：探讨分化型甲状腺癌（DTC）淋巴结转移患者血清甲状腺球蛋白（Tg）未检出的原因。方法：对DTC淋巴结转移患者的FNAB冲洗液和免疫分析法（Tg- ia）检测不到的血清Tg进行Tg和抗Tg抗体（TgAb）的检测。在血清中进行尖峰恢复实验以评估无法检测到Tg的原因。结果：42例患者中，87%的患者通过Tg- ia和83%的患者通过Tg- ms在FNAB冲洗液中检测到Tg。其中76%的患者血清中检测到TgAb， 26%没有。对TgAb+（阳性）血清样品进行的Tg峰值回收率实验显示，Tg- ia法降低了Tg回收率，而Tg- ms法没有(Tg- ia平均值，范围：50%，12-84%；Tg-MS 96%, 70-117%)。在TgAb-（阴性）血清样品中，未观察到干扰（回收率为0.94%）。TgAb-和TgAb+患者的FNAB冲洗液Tg恢复无差异。结论：Tg可以通过Tg- ia和Tg- ms两种方法检测到大多数DTC淋巴结转移患者的FNAB冲洗液。血清Tg的缺失不能完全用TgAb的存在来解释。这些结果表明，对于一部分DTC淋巴结转移患者，血清中检测不到Tg似乎不是由于当前Tg测定的分析局限性或TgAb干扰的存在。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.