Are Thyroglobulin Antibody Levels a Reliable Indicator of Thyroid Cancer Recurrence?
Posted: Friday, June 19, 2020
Elevated thyroglobulin antibody levels in patients with negative thyroglobulin levels while receiving immunoglobulin therapy may not accurately predict recurrence of thyroid cancer, according to a study presented during the ENDO2020 Virtual Scientific Program (Abstract MON-448) and published in the Journal of the Endocrine Society. However, the use of liquid chromatography-mass spectrometry may provide clarity in differentiating thyroid cancer recurrence, according to Adeyinka Taiwo, MBBS, and Ayotunde Dokun, MD, PhD, both of the University of Iowa Hospitals and Clinics, Iowa City.
A patient clinical case analysis revealed an incidental left thyroid nodule determined to be papillary thyroid cancer. Total resection of the thyroid was performed, with no evidence of lymphovascular invasion (stage T1bN0M0). The patient was administered 105.3 mCi of radioactive iodine. A whole-body thyroid scan revealed increased radioactive iodine uptake in residual thyroid tissue. The patient was started on levothyroxine postoperatively and received monthly IV immunoglobulin and weekly subcutaneous immunoglobulin. Drs. Taiwo and Dokun aimed to detect recurrence in patients with normal thyroglobulin levels who were receiving immunoglobulin therapy and had increased thyroglobulin antibody levels.
The investigators discovered the patient had variable thyroid stimulating hormone levels, ranging from 14.91 to 0.04 uIU/mL, but consistent thyroglobulin titer levels below 0.1 ng/mL. In addition, the patient’s thyroglobulin antibody titers increased consistently to 49 IU/mL after 5 years of radioactive iodine therapy.
In closing, Drs. Taiwo and Dokun noted that thyroglobulin antibody levels “may not be a reliable indicator of thyroid cancer recurrence. Measurement of thyroglobulin levels using liquid chromatography-mass spectrometry may provide some clarity.”
Disclosure: For full disclosures of the study authors, visit academic.oup.com.