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Low thyroglobulin concentrations after thyroidectomy increase the prognostic value of undetectable thyroglobulin levels on levo-thyroxine suppressive treatment in low-risk differentiated thyroid cancer.
J Endocrinol Invest 2010; 33(2):83-7JE

Abstract

DESIGN

Recombinant human TSH-stimulated thyroglobulin (Tg) levels (rhTSH-Tg) are sufficient for early follow-up of low-risk differentiated thyroid cancer (DTC) patients after thyroidectomy and radioiodine (131I) remnant ablation (RAI). Serum Tg levels at the time of remnant ablation (ablation-Tg) is thought to be related with rhTSH-Tg and may be predictive of recurrent disease. During long-term follow-up, Tg levels on levo-T4 (L-T4) suppressive treatment (suppressive-Tg) is sufficiently sensitive to avoid further evaluations in patients with undetectable rhTSH-Tg. The aim of our study was to verify whether, in a subgroup of low-risk DTC patients, the association of low ablation-Tg levels (<10 microg/l) with undetectable suppressive-Tg concentrations has a sufficient negative predictive value (NPV) for recurrence of disease, leading to avoid rhTSH testing.

METHODS

We enrolled 169 low-risk DTC patients treated by thyroidectomy + RAI and undetectable suppressive-Tg at 12-month followup. In all patients, we retrospectively evaluated ablation-Tg and rhTSH-Tg. For all patients, 2-yr follow-up was available.

RESULTS

Based on rhTSH-Tg>2 microg/l, relapsing disease was histologically proven in 2 patients. rhTSH-Tg levels between 0.6-2.0 microg/l, with no evidence of disease, was observed in 10 patients (6%). One hundred and fifty-seven patients showed undetectable rhTSH-Tg. The NPV of undetectable suppressive- Tg was 92.8%. The ablation-Tg level was <10 microg/l in 140 patients. In this group, the NPV of undetectable suppressive- Tg was 100%.

CONCLUSION

Our data indicate that undetectable suppressive-Tg value, combined with ablation- Tg levels <10 microg/l, may avoid a significant number of high-cost rhTSH-Tg test.

Authors+Show Affiliations

Department of Nuclear Medicine, Galliera Hospital, Mura delle Cappuccine 14, Genoa, Italy. arnoldo.piccardo@galliera.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19636213

Citation

Piccardo, A, et al. "Low Thyroglobulin Concentrations After Thyroidectomy Increase the Prognostic Value of Undetectable Thyroglobulin Levels On Levo-thyroxine Suppressive Treatment in Low-risk Differentiated Thyroid Cancer." Journal of Endocrinological Investigation, vol. 33, no. 2, 2010, pp. 83-7.
Piccardo A, Arecco F, Morbelli S, et al. Low thyroglobulin concentrations after thyroidectomy increase the prognostic value of undetectable thyroglobulin levels on levo-thyroxine suppressive treatment in low-risk differentiated thyroid cancer. J Endocrinol Invest. 2010;33(2):83-7.
Piccardo, A., Arecco, F., Morbelli, S., Bianchi, P., Barbera, F., Finessi, M., ... Orlandi, F. (2010). Low thyroglobulin concentrations after thyroidectomy increase the prognostic value of undetectable thyroglobulin levels on levo-thyroxine suppressive treatment in low-risk differentiated thyroid cancer. Journal of Endocrinological Investigation, 33(2), pp. 83-7. doi:10.3275/6471.
Piccardo A, et al. Low Thyroglobulin Concentrations After Thyroidectomy Increase the Prognostic Value of Undetectable Thyroglobulin Levels On Levo-thyroxine Suppressive Treatment in Low-risk Differentiated Thyroid Cancer. J Endocrinol Invest. 2010;33(2):83-7. PubMed PMID: 19636213.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low thyroglobulin concentrations after thyroidectomy increase the prognostic value of undetectable thyroglobulin levels on levo-thyroxine suppressive treatment in low-risk differentiated thyroid cancer. AU - Piccardo,A, AU - Arecco,F, AU - Morbelli,S, AU - Bianchi,P, AU - Barbera,F, AU - Finessi,M, AU - Corvisieri,S, AU - Pestarino,E, AU - Foppiani,L, AU - Villavecchia,G, AU - Cabria,M, AU - Orlandi,F, Y1 - 2009/07/28/ PY - 2009/7/29/entrez PY - 2009/7/29/pubmed PY - 2010/6/25/medline SP - 83 EP - 7 JF - Journal of endocrinological investigation JO - J. Endocrinol. Invest. VL - 33 IS - 2 N2 - DESIGN: Recombinant human TSH-stimulated thyroglobulin (Tg) levels (rhTSH-Tg) are sufficient for early follow-up of low-risk differentiated thyroid cancer (DTC) patients after thyroidectomy and radioiodine (131I) remnant ablation (RAI). Serum Tg levels at the time of remnant ablation (ablation-Tg) is thought to be related with rhTSH-Tg and may be predictive of recurrent disease. During long-term follow-up, Tg levels on levo-T4 (L-T4) suppressive treatment (suppressive-Tg) is sufficiently sensitive to avoid further evaluations in patients with undetectable rhTSH-Tg. The aim of our study was to verify whether, in a subgroup of low-risk DTC patients, the association of low ablation-Tg levels (<10 microg/l) with undetectable suppressive-Tg concentrations has a sufficient negative predictive value (NPV) for recurrence of disease, leading to avoid rhTSH testing. METHODS: We enrolled 169 low-risk DTC patients treated by thyroidectomy + RAI and undetectable suppressive-Tg at 12-month followup. In all patients, we retrospectively evaluated ablation-Tg and rhTSH-Tg. For all patients, 2-yr follow-up was available. RESULTS: Based on rhTSH-Tg>2 microg/l, relapsing disease was histologically proven in 2 patients. rhTSH-Tg levels between 0.6-2.0 microg/l, with no evidence of disease, was observed in 10 patients (6%). One hundred and fifty-seven patients showed undetectable rhTSH-Tg. The NPV of undetectable suppressive- Tg was 92.8%. The ablation-Tg level was <10 microg/l in 140 patients. In this group, the NPV of undetectable suppressive- Tg was 100%. CONCLUSION: Our data indicate that undetectable suppressive-Tg value, combined with ablation- Tg levels <10 microg/l, may avoid a significant number of high-cost rhTSH-Tg test. SN - 1720-8386 UR - https://www.unboundmedicine.com/medline/citation/19636213/Low_thyroglobulin_concentrations_after_thyroidectomy_increase_the_prognostic_value_of_undetectable_thyroglobulin_levels_on_levo_thyroxine_suppressive_treatment_in_low_risk_differentiated_thyroid_cancer_ L2 - https://link.springer.com/article/10.1007/BF03346558 DB - PRIME DP - Unbound Medicine ER -