engleski

The Value of Preablative Stimulated Thyroglobulin for Predicting the Recurrent and Persistent Disease of Differentiated Thyroid Cancer

Objective: We investigated the clinical importance of stimulated serum thyroglobulin at the time of radioiodine treatment (preablative Tg) for predicting the recurrent and persistent disease of differentiated thyroid cancer (DTC). Methods: The study included 235 consecutive patients with DTC submitted to total thyroidectomy and radioiodine ablation between 2005 and 2015 at University Hospital Osijek. Patients with positive anti-Tg antibodies were excluded from the study. Cut-off value of preablative Tg level was set to equal or grater than 10 ng/ml to test predictive value of preablative Tg for recurrent disease. Results: Clinically persistent or recurrent disease was diagnosed in 34/235 patients (14, 4%). Preablative stimulated Tg was elevated (≥ 10) in 62 patients and clinical (structural) recurrence was observed in 29 of these patient. Positive predictive value (PPV) of preablative Tg was 46, 7%. Preablative Tg ≥ 10 ng/ml was measured in 29/34 patients with recurrence (sensitivity: 85%). Negative predictive value (NPV) was 97% when preablative Tg value was less than 10 ng/ml. Persistent disease was diagnosed just in 5 cases (3%). Conclusions: The stimulated Tg level measured before radioiodine ablation (preablative Tg) significantly increases risk of recurrence in patients with DTC if its value was ≥ 10 ng/ml. Preablative Tg is useful negative predictor of persistent and recurrent disease. Patients with preablative Tg value of less than 10 ng/ml had only 3% likelihood of persistent DTC. Patients with preablative Tg ≥ 10 ng/ml had 15, 6 times greater chance of recurrent disease than those with values < 10 ng/ml.

thyroglobulin ; differentiated thyroid cancer

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