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[On-levothyroxine measurement of thyroglobulin is not a reliable test for the follow-up of patients at high risk for remnant/recurrent differentiated thyroid carcinoma].
- Source :
-
Endokrynologia Polska [Endokrynol Pol] 2007 Mar-Apr; Vol. 58 (2), pp. 100-4. - Publication Year :
- 2007
-
Abstract
- Introduction: At present the most widely accepted tool for follow-up management of differentiated thyroid cancer (DTC) patients is serum thyroglobulin (Tg) measurement. It is not uncommon for the serum Tg level to be measured while the patient is taking thyroid hormones (on-treatment Tg measurement). The purpose of the study was to evaluate the accuracy of on-treatment measurement of serum Tg in detecting remnant/recurrent or metastatic disease in high-risk DTC patients.<br />Material and Methods: We retrospectively analysed the medical records of 26 high-risk DTC patients and compared the on-treatment and off-treatment Tg levels of these patients. All patients were anti-Tg negative. Using off-treatment measurement of Tg as the gold standard, the results of on-treatment measurement of Tg in the diagnosis of remnant/recurrent disease were analysed for sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV).<br />Results: The median serum Tg level under thyroid hormone suppressive therapy (on-treatment Tg) was 16.5 ng/ml and after withdrawal of thyroid hormone suppressive therapy (off-treatment Tg) was 95.0 ng/ml (P value = 0.001). In 6 patients (23%) the on-treatment Tg level missed the recurrence of the disease. Regarding the off-treatment Tg as the gold standard, the sensitivity, specificity, PPV and NPV of the on-treatment Tg measurement were 72.7%, 100%, 100%, and 40% respectively.<br />Conclusion: Normal serum Tg level without TSH-stimulation (on-treatment) is not diagnostically reliable in the follow-up of DTC patients with a high probability of residual/recurrent or metastatic disease.
- Subjects :
- Adult
Antineoplastic Agents, Hormonal therapeutic use
Carcinoma, Papillary, Follicular blood
Carcinoma, Papillary, Follicular drug therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Recurrence, Local blood
Neoplasm, Residual blood
Predictive Value of Tests
Retrospective Studies
Sensitivity and Specificity
Thyroid Hormones therapeutic use
Thyroid Neoplasms blood
Thyroid Neoplasms drug therapy
Thyroid Neoplasms secondary
Thyroidectomy
Biomarkers, Tumor blood
Carcinoma, Papillary, Follicular diagnosis
Neoplasm Recurrence, Local diagnosis
Neoplasm, Residual diagnosis
Thyroglobulin blood
Thyroid Neoplasms diagnosis
Thyroxine therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0423-104X
- Volume :
- 58
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Endokrynologia Polska
- Publication Type :
- Academic Journal
- Accession number :
- 17578824