Additional value of a high sensitive thyroglobulin assay in the follow-up of patients with differentiated thyroid carcinoma

• DOI: 10.1111/cen.13180
• Publication Date: 2016-09-02T16:57:33Z
• Authors: Andries H. Groen; Mariëlle S. Klein...; John T.M. Plukker; Wim J. Sluiter; Anouk N.A. van de...; Adrienne H. Brouwers; Eef G.W.M. Lentjes; Anneke C. Muller ...; Thera P. Links
• Keywords: Adult; Male; Thyroid Function Tests; Thyroglobulin; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; MANAGEMENT; Biomarkers, Tumor; Humans; CANCER PATIENTS; Postoperative Period; Thyroid Neoplasms; Retrospective Studies; SERUM THYROGLOBULIN; Remission Induction; Middle Aged; PAPILLARY; 3. Good health; REFERENCE MATERIAL CRM-457; LIFE; TG ASSAY; Catheter Ablation; Female; Follow-Up Studies

Thyroglobulin (Tg) is an excellent tumour marker, as detectable or increasing Tg levels are highly indicative of persistent or recurrent differentiated thyroid carcinoma (DTC). The clinical value of a highly sensitive (hs)-Tg assay in patients with DTC has not yet been established. The aim of this study was to investigate the additional value of unstimulated hs-Tg measurements (Tg-on) compared to stimulated IRMA-Tg measurements (Tg-off) in the follow-up of patients with DTC.We retrospectively studied patients treated for DTC between 2006 and 2013 and compared hs-Tg and IRMA-Tg measurements. The study group consisted of 99 DTC patients in remission; Tg-on was measured 3 months after remnant ablation and Tg-off 6 months after ablation.In the study group, 44 patients showed a hs-Tg-on <0·15 μg/l (functional sensitivity); of these, 43 had an IRMA-Tg-off measurement <1·0 μg/l, resulting in a negative predictive value of 97·7% and a positive predictive value of 56·4%.The hs-Tg-on measurement is able to predict patients with an IRMA-Tg-off <1·0 μg/l, and therefore decreases the need for Tg stimulation after ablation.