Role of Thyroglobulin in Detecting Recurrence of Thyroid Cancer After Surgery
Posted: Monday, June 15, 2020
According to a study published in The Journal of Clinical Endocrinology & Metabolism, serum thyroglobulin, when used independently, seems to have limited predictive value in detecting the recurrence of papillary thyroid cancer in patients who have had thyroid lobectomy. The results suggest that in cases with very high levels of thyroglobulin or with significant increases over time, it may have the potential to guide complete thyroidectomy. However, the supporting evidence is not well founded. Neck ultrasonography currently remains the standard modality for patients after thyroid lobectomy, the researchers concluded.
“While thyroglobulin is a well-established component of the 2015 American Thyroid Association response to therapy system following total thyroidectomy and radioiodine ablation, its interpretation following lobectomy is challenging,” Amit Ritter, MD, of Tel Aviv University, Israel, and colleagues reported.
The research team retrospectively evaluated 167 patients who underwent lobectomy for papillary thyroid cancer. Eligible patients were followed for at least 1 year, and there were sufficient data on the use of thyroglobulin and thyroglobulin antibodies. The researchers measured thyroglobulin levels, thyroglobulin antibody levels, and thyroid-stimulating hormone levels after surgery annually for a maximum of 6 years.
Following lobectomy, the mean thyroglobulin level was 12.1 ± 14.8 ng/mL. In the first 2 years of follow-up, thyroglobulin levels decreased in 42%, remained stable in 22%, and increased in 36% of the patient pool. During the 6.5-year follow-up, 18 patients underwent completion thyroidectomy. Of those patients, 12 were diagnosed with contralateral cancer (n = 8) or lymph node metastases (n = 4). Of the patients who experienced disease recurrence, three had an increase in thyroglobulin levels, two had stable levels, and one had a decrease in thyroglobulin antibodies despite having metastatic lymph nodes.
Disclosure: The study authors reported no conflicts of interest.