Manish Ora, Aftab Hasan Nazar, Prabhakar Mishra, Sukanta Barai, Amitabh Arya, Prasanta Kumar Pradhan, Sanjay Gambhir
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Patients with IR had higher baseline TgAb (1071.27 ± 1216.17 vs. 99.61 ± 91.29 IU/ml, p < 0.001) and central compartment lymph node metastases (70.8% vs. 46.4%, p = 0.035) in comparison to those in the ER group. In the first follow-up, 64 (84.2%) patients had a stable or fall in the TgAb (0 to - 98.3%). Sixty-eight patients received high-dose radioiodine therapy (RIT). Out of these, 59 (86.5%) had transient, and 51 (75%) had a long-term fall in TgAb. After a follow-up period of 58.74 ± 26.26 months, 63.2% (48 out of 76) patients had IR. Nine (11.8%) patients had a rising TgAb level (3.7-170.9%) from baseline. Eleven patients underwent 18F-FDG PET/CT, and five of them demonstrated metabolically active recurrent disease. Three patients underwent cervical lymph nodes dissection. None of the patients died during the follow-up period.</p><p><strong>Conclusion: </strong>High post-operative TgAb levels and central compartment lymph nodal metastases are risk factors for IR. RIT leads to a significant fall in the TgAb in these patients. The low level of raised TgAb is associated with an excellent outcome. Patients with recurrences had very high baseline TgAb > 1000 IU/ml. Raised TgAb was associated with good clinical outcomes and not associated with increased mortality.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"14 1","pages":"8"},"PeriodicalIF":1.9000,"publicationDate":"2021-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8048259/pdf/","citationCount":"3","resultStr":"{\"title\":\"Clinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels: a retrospective study.\",\"authors\":\"Manish Ora, Aftab Hasan Nazar, Prabhakar Mishra, Sukanta Barai, Amitabh Arya, Prasanta Kumar Pradhan, Sanjay Gambhir\",\"doi\":\"10.1186/s13044-021-00099-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Thyroglobulin (Tg) is a specific tumor marker for differentiated thyroid cancer (DTC). 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Out of these, 59 (86.5%) had transient, and 51 (75%) had a long-term fall in TgAb. After a follow-up period of 58.74 ± 26.26 months, 63.2% (48 out of 76) patients had IR. Nine (11.8%) patients had a rising TgAb level (3.7-170.9%) from baseline. Eleven patients underwent 18F-FDG PET/CT, and five of them demonstrated metabolically active recurrent disease. Three patients underwent cervical lymph nodes dissection. None of the patients died during the follow-up period.</p><p><strong>Conclusion: </strong>High post-operative TgAb levels and central compartment lymph nodal metastases are risk factors for IR. RIT leads to a significant fall in the TgAb in these patients. The low level of raised TgAb is associated with an excellent outcome. Patients with recurrences had very high baseline TgAb > 1000 IU/ml. 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引用次数: 3
摘要
背景:甲状腺球蛋白(Tg)是分化型甲状腺癌(DTC)的特异性肿瘤标志物。然而，在抗甲状腺球蛋白抗体(TgAb)的存在下，它变得不可靠。该研究的目的是评估TgAb升高的DTC患者的长期预后。方法:在一项回顾性研究中，我们纳入了甲状腺全切除术后TgAb升高的DTC患者。我们排除了持续升高Tg(≥1 ng/ml)或放射性碘疾病的患者。评估连续TgAb水平、良好反应(ER)、不完全反应(IR)和解剖性复发。结果:共有76例患者纳入研究。IR患者的TgAb基线较高(1071.27±1216.17 vs. 99.61±91.29 IU/ml)， p结论:术后TgAb高水平和中央室淋巴结转移是IR的危险因素。RIT导致这些患者TgAb显著下降。低水平的TgAb升高与良好的预后相关。复发患者的TgAb基线非常高，> 1000 IU/ml。TgAb升高与良好的临床结果相关，与死亡率升高无关。
Clinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels: a retrospective study.
Background: Thyroglobulin (Tg) is a specific tumor marker for differentiated thyroid cancer (DTC). However, in the presence of an antithyroglobulin antibody (TgAb), it becomes unreliable. The purpose of the study was to assess the long-term outcome of DTC patients with raised TgAb.
Method: In a retrospective study, we included patients with DTC who had raised TgAb following total thyroidectomy. We excluded patients with persistently raised Tg (≥ 1 ng/ml) or radioiodine avid disease. Serial TgAb levels, excellent response (ER), incomplete response (IR), and anatomical recurrence were evaluated.
Results: A total of seventy-six patients were included in the study. Patients with IR had higher baseline TgAb (1071.27 ± 1216.17 vs. 99.61 ± 91.29 IU/ml, p < 0.001) and central compartment lymph node metastases (70.8% vs. 46.4%, p = 0.035) in comparison to those in the ER group. In the first follow-up, 64 (84.2%) patients had a stable or fall in the TgAb (0 to - 98.3%). Sixty-eight patients received high-dose radioiodine therapy (RIT). Out of these, 59 (86.5%) had transient, and 51 (75%) had a long-term fall in TgAb. After a follow-up period of 58.74 ± 26.26 months, 63.2% (48 out of 76) patients had IR. Nine (11.8%) patients had a rising TgAb level (3.7-170.9%) from baseline. Eleven patients underwent 18F-FDG PET/CT, and five of them demonstrated metabolically active recurrent disease. Three patients underwent cervical lymph nodes dissection. None of the patients died during the follow-up period.
Conclusion: High post-operative TgAb levels and central compartment lymph nodal metastases are risk factors for IR. RIT leads to a significant fall in the TgAb in these patients. The low level of raised TgAb is associated with an excellent outcome. Patients with recurrences had very high baseline TgAb > 1000 IU/ml. Raised TgAb was associated with good clinical outcomes and not associated with increased mortality.
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