Clinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels: a retrospective study
Abstract 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...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | Thyroid Research |
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| Online Access: | https://doi.org/10.1186/s13044-021-00099-w |
| _version_ | 1819087664095166464 |
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| author | Manish Ora Aftab Hasan Nazar Prabhakar Mishra Sukanta Barai Amitabh Arya Prasanta Kumar Pradhan Sanjay Gambhir |
| author_facet | Manish Ora Aftab Hasan Nazar Prabhakar Mishra Sukanta Barai Amitabh Arya Prasanta Kumar Pradhan Sanjay Gambhir |
| author_sort | Manish Ora |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-21T21:39:44Z |
| format | Article |
| id | doaj.art-b31d61f33a27459c9e6c5c915cd195e4 |
| institution | Directory Open Access Journal |
| issn | 1756-6614 |
| language | English |
| last_indexed | 2024-12-21T21:39:44Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Thyroid Research |
| spelling | doaj.art-b31d61f33a27459c9e6c5c915cd195e42022-12-21T18:49:24ZengBMCThyroid Research1756-66142021-04-0114111010.1186/s13044-021-00099-wClinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels: a retrospective studyManish Ora0Aftab Hasan Nazar1Prabhakar Mishra2Sukanta Barai3Amitabh Arya4Prasanta Kumar Pradhan5Sanjay Gambhir6Department of Nuclear Medicine, SGPGIMSDepartment of Nuclear Medicine, SGPGIMSDepartment of Biostatistics and Health Informatics, SGPGIMSDepartment of Nuclear Medicine, SGPGIMSDepartment of Nuclear Medicine, SGPGIMSDepartment of Nuclear Medicine, SGPGIMSDepartment of Nuclear Medicine, SGPGIMSAbstract 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.https://doi.org/10.1186/s13044-021-00099-wDifferentiated thyroid cancerSerum antithyroglobulin antibodyRadioiodine therapyRecurrence |
| spellingShingle | Manish Ora Aftab Hasan Nazar Prabhakar Mishra Sukanta Barai Amitabh Arya Prasanta Kumar Pradhan Sanjay Gambhir Clinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels: a retrospective study Thyroid Research Differentiated thyroid cancer Serum antithyroglobulin antibody Radioiodine therapy Recurrence |
| title | Clinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels: a retrospective study |
| title_full | Clinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels: a retrospective study |
| title_fullStr | Clinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels: a retrospective study |
| title_full_unstemmed | Clinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels: a retrospective study |
| title_short | Clinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels: a retrospective study |
| title_sort | clinical outcome of patients with differentiated thyroid cancer and raised antithyroglobulin antibody levels a retrospective study |
| topic | Differentiated thyroid cancer Serum antithyroglobulin antibody Radioiodine therapy Recurrence |
| url | https://doi.org/10.1186/s13044-021-00099-w |
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