Clinical evaluation of a new thyroglobulin immunoradiometric assay in the follow-up of differentiated thyroid carcinoma

2003 ◽  
Vol 42 (02) ◽  
pp. 71-77 ◽  
Author(s):  
I. Schreivogel ◽  
C. Angerstein ◽  
U. Siefker ◽  
K. Lehmann ◽  
G. Altenvoerde ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Residual Disease ◽  
False Negative ◽  
Differentiated Thyroid Carcinoma ◽  
Threshold Concentration ◽  
High Rate ◽  
Functional Assay ◽  
Hypothyroid Patient ◽  
Assay Sensitivity ◽  
Significant Difference

SummaryAim: Formal and clinical comparison of a new 3rd-gene-ration-Tg-IRMA (3-G-IRMA; Dynotest®Tg-plus) with a conventional Tg-IRMA (3-G-IRMA; SELco®Tg-assay) for patients with differentiated thyroid carcinoma. In addition we evaluated, if thyroglobulin (Tg) levels above a specific threshold concentration indicate the need for further investigations for residual disease. Patients, methods: Tg concentration of 105 sera of 93 consecutive patients with a differentiated thyroid cancer was determined with both assays and compared at different cut-off values (Dynotest®Tg-plus: 0.2, 1, 2 ng/ml; SELco®Tg-assay: 0.5, 1, 2 ng/ml) with the clinical results in respect to the corresponding TSH concentration. Results: Tg concentration did not show any significant difference (SELco®Tg-assay 0.5 ng/ml, Dynotest® Tg-plus 0.2 ng/ml). The Tg-values of both assays correlated with 97%. However, correlation of recovery in both assays was small (40%). The sensitivities and specificities of both assays at different cut-offs and TSH values did not reveal significant differences. In patients with TSH concentration >30 µU/ml the functional assay sensitivity was superior to arbitrary cut-offs in the decision to start further evaluations. Conclusions: In our study neither formal nor clinical significant differences between two Tg-assays were found. In a hypothyroid patient (TSH >30 µU/ml, Tg concentration exceeding the functional assay sensitivity) further investigations for residual disease are warranted. Higher thresholds are of limited value, due to a inacceptable high rate of false negative results.

CTLA-4 gene polymorphisms associate with efficacy of postoperative radioiodine-131 for differentiated thyroid carcinoma (Retracted)

2017 ◽  
Vol 13 (12) ◽  
pp. 1057-1068 ◽  
Author(s):  
De-Feng Chang ◽  
Xiao-Hong Chen ◽  
Jing Huang ◽  
Ya-Mei Sun ◽  
Da-Yong Zhu ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Chromosome Aberration ◽  
Gene Polymorphisms ◽  
Differentiated Thyroid Carcinoma ◽  
Significant Difference ◽  
Retraction Notice

This article was retracted on 13th of March 2020 This article has been retracted from Future Oncology due to a miscalculation that incorrectly suggested a significant difference in chromosome aberration complications (Table 5: +49A>G) Retraction notice

scholarly journals Long-Term Oncological Outcome Comparison between Intermediate- and High-Dose Radioactive Iodine Ablation in Patients with Differentiated Thyroid Carcinoma: A Propensity Score Matching Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Kwangsoon Kim ◽  
Ja Seong Bae ◽  
Jeong Soo Kim
Keyword(s):  
Propensity Score ◽  
Thyroid Carcinoma ◽  
Propensity Score Matching ◽  
Radioactive Iodine ◽  
Differentiated Thyroid Carcinoma ◽  
High Dose ◽  
Preoperative Serum ◽  
Significant Difference ◽  
Intermediate Dose

Background. Radioactive iodine (RAI) ablation is recommended for most patients with differentiated thyroid carcinoma (DTC) after total thyroidectomy (TT). We aimed to compare long-term outcomes between intermediate-dose (100 mCi) and high-dose (150 mCi) RAI ablation therapy in patients with DTC using propensity score matching analysis. Methods. This was a retrospective study of 1448 patients with DTC who underwent RAI ablation after TT. Propensity score matching was performed using the extent of operation, tumor size, extrathyroidal extension, multifocality, lymphatic invasion, vascular invasion, perineural invasion, number of positive lymph nodes (LNs), ATA risk stratification system, T stage, N stage, TNM stage, preoperative serum Tg and TgAb levels, and post-RAI serum Tg and TgAb levels. Results. Recurrence rates in the intermediate- and high-dose groups were 3.1% and 5.6%, respectively. After propensity score matching, LN ratio >0.22 (HR, 2.915; 95% CI, 1.228–6.918; p = 0.015 ) and serum Tg >10 ng/mL after RAI (HR, 3.976; 95% CI, 1.839–8.595; p < 0.001 ) were significant predictors of recurrence. Kaplan–Meier analysis showed no significant difference in DFS before or after propensity score matching ( p = 0.074 and p = 0.378 , respectively). Conclusions. Intermediate-dose RAI ablation for the adjuvant treatment of DTC is sufficient as compared to high-dose RAI ablation. Further prospective or multicenter studies should be conducted to clarify the prognosis of intermediate-dose RAI ablation.

scholarly journals Recombinant Human Thyrotropin Stimulation of Fluoro-d-Glucose Positron Emission Tomography Uptake in Well-Differentiated Thyroid Carcinoma

2004 ◽  
Vol 89 (1) ◽  
pp. 91-95 ◽  
Author(s):  
Bennett B. Chin ◽  
Pavni Patel ◽  
Christian Cohade ◽  
Marge Ewertz ◽  
Richard Wahl ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Thyroid Carcinoma ◽  
Fdg Pet ◽  
Residual Disease ◽  
Differentiated Thyroid Carcinoma ◽  
Emission Tomography ◽  
Tsh Suppression ◽  
Positron Emission ◽  
Well Differentiated ◽  
Recombinant Human Thyrotropin

TSH stimulates thyrocyte metabolism, glucose transport, and glycolysis. 2-Deoxy-2-[18F]fluoro-d-glucose (FDG) is a glucose analog used in positron emission tomography (PET) to detect occult well-differentiated thyroid carcinoma. The objective of this study was to examine the effects of recombinant human TSH (rTSH) on FDG PET uptake in patients with residual or recurrent disease. Seven patients with well-differentiated thyroid carcinoma, negative 131-I scintigraphy, and biochemical evidence of residual disease were randomized and prospectively studied with FDG PET both on thyroid hormone suppression and rTSH stimulation within 1 wk. All lesions seen on the TSH suppression scans were seen on the rTSH stimulation studies. rTSH stimulation studies identified four additional lesions not seen on TSH suppression. One patient was positive on rTSH stimulation alone. The mean (2.54 ± 0.72 vs. 1.79 ± 0.88) and maximum (2.49 ± 0.95 vs. 1.74 ± 0.81) lesion to background ratios were significantly higher with rTSH stimulation, compared with TSH suppression (P = 0.02 for both). rTSH stimulation improves the detectability of occult thyroid metastases with FDG PET, compared with scans performed on TSH suppression.

Prognostic factors and follow-up of patients with differentiated thyroid carcinoma with false negative or nondiagnostic FNAC before surgery. Comparison with a control group

Endocrine ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 423-431 ◽  
Author(s):  
Luis García-Pascual ◽  
Montserrat Balsells ◽  
Matteo Fabbi ◽  
Carlos del Pozo ◽  
María-Teresa Valverde ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Thyroid Carcinoma ◽  
False Negative ◽  
Differentiated Thyroid Carcinoma ◽  
Control Group

The utility of 18-F-fluorodeoxyglucose positron emission tomography in evaluation of bone marrow involvement by non-Hodgkin lymphoma (NHL)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 8077-8077
Author(s):  
A. Muslimani ◽  
H. Farag ◽  
S. Francis ◽  
T. P. Spiro ◽  
H. A. Daw ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
False Negative ◽  
Pet Scan ◽  
High Rate ◽  
Whole Body ◽  
Image Guided ◽  
Significant Difference ◽  
Fdg Pet Scan

8077 Introduction: In NHL, the anatomic extent of the disease is an important factor influencing the overall survival. Clinically, NHLs are classified as indolent, aggressive, or highly aggressive. Bone marrow (BM) involvement is a sign of extensive disease, and iliac crest (IC) BM biopsy (BMB) is the established method for the detection of BM infiltration. However, IC BMB is associated with a high rate of false- negative result. We assess the ability of 18F-FDG PET scan to ascertain the presence of BM involvement in NHL. Methods: We retrospectively reviewed charts from January 2002 through November 2006 of histologically proven NHLs. 87 patients (pts) were eligible for our study (38 males, 49 females; age range 42–81 years). All pts were examined by whole-body 18F-FDG-PET scan for initial staging, and all had unilateral posterior IC BMB. BM involvement was established following the result of 1) unilateral posterior IC BMB, and 2) image-guided BMB following positive 18F-FDG-PET scan in selected patients. Results: Among the PET+ / IC BMB- group, 3 pts had a positive CT-scan guided BMB at the site of involvement detected by the 18F-FDG-PET scan (2 from the humerus,1 from the femur); the remaining 7 pts did not have a site-directed biopsy. Our data demonstrate an overall sensitivity of 0.76 for the PET scan detecting BM involvement in all pts and specificity of 0.88. We point out that the 0.88 specificity may be spuriously low, this is a result of the fact that of the 10 PET+ / IC BMB- pts 7 have not had directed biopsy to the site of involvement detected by the18F-FDG- PET-scan. Further analysis revealed no significant difference between the sensitivity (P = 0.21) and specificity (p = 0.99) between I- NHL and A/HA- NHL groups. Conclusion: 18F-FDG-PET scan shows potential to detect BM involvement in NHL. In particular, image-guided repeat BMB may be considered in pts with negative initial IC BMB, whose 18F-FDG-PET scan demonstrates BM involvement in a different site. No significant financial relationships to disclose. [Table: see text]

scholarly journals The Efficacy of Thyrotropin Suppression Therapy in Treatment of Differentiated Thyroid Cancer after Total Thyroidectomy

2015 ◽  
Vol 6 (2) ◽  
pp. 24-33
Author(s):  
Niveen A. Abo-Touk ◽  
Dalia H. Zayed
Keyword(s):  
Thyroid Cancer ◽  
High Risk ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Cancer ◽  
Tumour Size ◽  
Differentiated Thyroid Carcinoma ◽  
Tsh Suppression ◽  
Significant Difference ◽  
Tsh Suppression Therapy ◽  
Disease Free

AbstractBackground: The aim of this prospective study was to assess the effect of the TSH suppression on both disease-free and overall survivals in patients with nonmetastatic differentiated thyroid cancer (DTC) after total thyroidectomy.Patients & Methods: One hundred and forty eight patients with pathologically proved operable differentiated thyroid carcinoma were enrolled in this prospective study. Levothyroxin (L-T4) therapy was started in doses according to treatment groups. Patients were randomly assigned to receive either postoperative TSH suppression therapy in group I (76 patients) or nonsuppression therapy in group II (72 patients).Results: During the period of follow up with a median 54 months, the disease-free survival for patients without TSH suppression therapy did not reach statistically significant difference comparing with those for patients with the suppression therapy (p=0.09). However, the difference was statistically significant for high-risk patients (p=0.04). On comparing both groups there was no statistically significant difference with regard to overall survival (p=0.17). The age of the patients more than 45 years, tumour size more than 4 cm and high-risk group were significant independent predictors for thyroid carcinoma-related relapse in univariate analysis. However, tumour size was the only significant factor in multivariate analysis.Conclusion: Suppressive treatment with L-T4 therapy in patients with differentiated thyroid carcinoma should be individualised and balanced against the adverse effects. TSH suppression is indicated in patients with high-risk disease or recurrent tumour. Normalisation of serum TSH is preferred for long-term treatment of disease-free elderly patients with DTC and comorbidities.

Measuring thyroglobulin in patients with thyroglobulin autoantibodies: evaluation of the clinical impact of BRAHMS Kryptor® Tg-minirecovery test in a large series of patients with differentiated thyroid carcinoma

2019 ◽  
Vol 57 (8) ◽  
pp. 1185-1191 ◽  
Author(s):  
Luca Giovanella ◽  
Frederik A. Verburg ◽  
Pierpaolo Trimboli ◽  
Mauro Imperiali ◽  
Franco Keller ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Recurrent Disease ◽  
Clinical Status ◽  
False Negative ◽  
Differentiated Thyroid Carcinoma ◽  
Clinical Impact ◽  
Large Series ◽  
Serum Samples ◽  
Roc Curve Analysis ◽  
True Negative

Abstract Background The present study was undertaken to evaluate the clinical impact of a thyroglobulin (Tg) minirecovery test (Tg-mRec) in a large series of differentiated thyroid carcinoma (DTC) patients treated and monitored homogeneously in a tertiary referral center. Methods Included were 1120 serum samples from 798 DTC patients. Tg, Tg autoantibodies (TgAb) and Tg-mrec measurements were performed on the automated Kryptor® platform and results compared to the corresponding clinical status. Results Among included samples 228 (20%) were TgAb-positive (TgAb+) and 892 (80%) TgAb-negative (TgAb−), respectively. Tg cutoff points were settled at 0.31 μg/L and 0.15 μg/L for TgAb− and TgAb+ patients, respectively, by ROC curve analysis. The diagnostic performance of serum Tg was reduced in TgAb+ compared to TgAb− patients, however, 87% of TgAb+ patients with recurrent disease and, particularly, all patients with distant metastases were correctly detected by adopting an optimized Tg cutoff for TgAb+ patients. A disturbed recovery was found in only 1% of TgAb− patients and in these cases no clinically relevant information was added by the Tg-mRec. Among TgAb+ patients with undetectable Tg and undisturbed Tg-mRec, no one had recurrent disease. However, a falsely undetectable Tg was demonstrated in two patients with recurrent disease who next to increased TgAb also had a disturbed Tg-mRec test. Conclusions There is no additional clinical benefit from performing Tg-mRec in most patients. It can however be considered in TgAb+ patients with undetectable Tg levels as it may help differentiate between patients with true negative and false negative Tg levels in the presence of such antibodies.

scholarly journals Outcome of Differentiated Thyroid Carcinoma at Two Centres in Kuantan, Pahang

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Nurul Fatihah Mohd Fuad
Keyword(s):  
Thyroid Carcinoma ◽  
Residual Disease ◽  
Medical Center ◽  
Medullary Carcinoma ◽  
Differentiated Thyroid Carcinoma ◽  
Treatment Modalities ◽  
Case Report Form ◽  
Chi Square ◽  
Disease Characteristics ◽  
Chi Square Test

Introduction: Differentiated thyroid carcinoma (DTC) is the commonest thyroid malignancy. Several studies had shown that the outcome of DTC depend on the patient’s age at time of diagnosis, tumor characteristics and initial treatment. The aim of this study was to describe the outcome of DTC and its associated factors among patients diagnosed at Hospital Tengku Ampuan Afzan (HTAA) and International Islamic University Malaysia Medical Center (IIUMMC) Kuantan, Pahang.  Materials and method:  A retrospective cohort study was carried out among all DTC patients in HTAA and IIUMMC from July 2018 to September 2018. Case report form was used for data collection and it consists of four sections that include sociodemography, disease characteristics, treatment modalities and outcome. Descriptive statistics was used to describe the types of DTC, sociodemographic characteristics, disease characteristics, treatment modalities and the outcome, while chi-square test was used to explore the factors that were associated with the outcome.  Result:  In DTC, majority were diagnosed with papillary carcinoma (93.5%) than medullary carcinoma (6.5%). Three-quarter of the patients had residual disease at 6 months and the disease persistent in more than half of the patients at 12 months. At two-years follow-up, most of the patients (56.5%) were in disease-free state followed by persistent (26.1%) and residual disease (17.4%). However, there were no significant factors that affect the outcome of the patients. Conclusion:  The two-year outcome post-treatment in this study revealed most of the patients were in remission.

scholarly journals Influence of lymphocitic thyroiditis on prognostic outcome differentiated thyroid carcinoma

2010 ◽  
Vol 57 (2) ◽  
pp. 85-94
Author(s):  
A. Filipovic ◽  
I. Paunovic ◽  
Lj. Vuckovic
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Thyroid Carcinoma ◽  
B Lymphocytes ◽  
Univariate Analysis ◽  
Lymphocytic Infiltration ◽  
Differentiated Thyroid Carcinoma ◽  
Significant Prognostic Factor ◽  
Poor Prognostic Factor ◽  
Significant Difference

Backgraund/aim. Thyroid carcinoma is rare malignant tumors. They are typically presented with slow progression and clinical course. Lymphocytic infiltration, including fagocytosis of neoplastic cells by macrophage plays an important role in preventing development of distant metastases. This paper sets the following objectives: Establish whether presence or absence of Hashimoto thyroiditis in differentiated thyroid carcinoma (DTC) is a favourable prognostic factor. Methods. The group under examination here are all newly diagnosed patients with differentiated thyroid carcinoma surgically treated at the Surgery Clinic in Podgorica from 2003. to 2010. A total of 125 patients, aged 11 to 79, were included in this research. The patients were divided in two groups, those with and those without lymphocytic infiltration. Both groups were mutually compared for their prognostic factors. For the identification of T and B lymphocytes, anti-CD 3 and anti-CD 20 antibodies were used. Student t-test was used for comparison of clinical and pathological parameters among groups, Hi square test for comparison of frequency, and Coxs regression model for time dependant variables as frequency of recurrence among groups with various stages of disease. Survival curve (Kaplan-Meier) is used for comparison of time dependant variables (survival, recurrence, death). The follow-up time ranges from 10 to 70 months in both groups of patients. Results are as follows: presence of lymphocytic infiltration in thyroid tissue in patients with differentiated thyroid carcinoma is significant prognostic factor (P<0.0001). But, absence of lymphocytic infiltration is a poor prognostic factor in patients with invasive extra thyroid tumours (P<0.0001). Also, absence of lymphocytic infiltration is a poor prognostic factor for development of lymphogenic and hematogenic metastases. The presence of T or B lymphocytes and varying degree of their presence is not a significant prognostic factor (P<0.0046). Patients without lymphocytic infiltration are significantly more numerous in the fourth stage of disease (P<0.0001). There is no statistically significant difference in terms of the presence of T or B lymphocytes in the tissue. Chronic lymphocytic thyroidis hahshimoto is a favourable prognostic factor in our examined group (P<0.0001). Local invasiveness and extrathyroid expansion is significantly smaller in the group of patients with the presence of lymphocytic infiltration (P<0.0001). By means of univariate analysis, we found that factors with a significant impact on survival rate include age (P<0.0001), size of tumour (P<0.018), extrathyroid invasiveness (P<0.0001), hematogenic metastases (P<0.049). Lymphocytic infiltration is present in 81% of patients in their thyroid gland, and in 19% patients there are no lymphocytes in tissue. Limphocitic infiltration has a favourable influence on tumor variables. Conclusion.This research has shown that lymphocytes in tissue as part of Hashimoto thzroiditis have an effect on certain prognostic factors of differentiated thyroid carcinoma as size, smaller invasiveness and extrathyroid tumour growth and incidence of hematogenic metastases.

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