SERUM THYROGLOBULIN AND ANTI THYROGLOBULIN LEVELS IN PATIENTS WITH THYROID NODULES

2020 ◽  
pp. 73-78
Author(s):  
Hung Nguyen Trung ◽  
Thuy Nguyen Hai ◽  
Quan Nguyen Phuoc Bao
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Serum Thyroglobulin ◽  
Elasticity Score ◽  
Thyroglobulin Level ◽  
The Mean ◽  
Operation Results ◽  
The Relationship ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Objectives: To compare the levels and pathological values of serum Tg and TgAb between the patients with benign and malignant thyroid nodules and evaluate the relationship between serum Tg and TgAb levels with the rim characteristic and elasticity score of the nodule by thyroid elasto-echography. Subjects: 30 patients with thyroid nodules, Serum Tg and TgAb levels and thyroid elasto-echography are examen before operation. Results: The ratio of the positive Tg level of malignant thyroid nodules was higher than the benign thyroid nodules (16.7% vs 8.3%) but the serum Tg level was not significantly different (33.48 ± 38.67 ng/ml vs 27.32 ± 28.44 ng/ml, p > 0.05) and The ratio of positive TgAb level of malignant thyroid nodules was higher than that of benign thyroid nodules (22.2% vs 0%) but serum TgAb level was not different (64.15 ± 14.91 UI/ml vs 16.9 ± 14.48 UI/ml, p > 0.05). The combination of the ratio of positive Tg and positive TgAb level did not show any difference in the ratio of pathological value between benign and malignant thyroid nodules (5.6% vs 0%). Serum Tg levels in patients with irregular rim thyroid nodules were higher than those in patients with regular rim thyroid nodules but the serum Tg level was not different when evaluated with the elastic score. Conclusions: The mean level and ratio of the pathological value of serum Tg and TgAb did not differ between malignant and benign thyroid nodules. There is a relationship between serum Tg level and irregular rim characteristic of thyroid nodule (p < 0.05). Key words: serum thyroglobulin level, serum anti thyroglobulin level, thyroid nodule.

scholarly journals MON-458 Elevated Thyroglobulin Level in Benign Thyroid Nodule

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Cara Murphy ◽  
Ankur Gupta
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Thyroid Peroxidase ◽  
Thyroglobulin Antibody ◽  
Patient Reported ◽  
Thyroglobulin Level ◽  
Neck Pressure ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Background: Elevated thyroglobulin levels are most commonly associated with differentiated thyroid carcinoma and these levels are often used to monitor for disease recurrence. Thyroglobulin antibody levels can be elevated in both Hashimoto’s Thyroiditis and Graves’ Disease and these antibodies can interfere with thyroglobulin levels as detailed by Spencer, Wang (1). With benign thyroid nodules, there is limited research regarding thyroglobulin levels as studied in Chinnappa, et al (2). Clinical Case: A 31-year woman presented with a palpable thyroid nodule and dysphagia. Her primary care physician ordered thyroid labs including normal TSH (1.3 mIU/L, n0.4-4 mIU/L), normal thyroid peroxidase antibody (56 units, n&lt;250units), normal thyroglobulin antibody level (&lt;1 IU/mL, n&lt;1 IU/mL), and elevated thyroglobulin level (469.1 ng/mL, n2.8-40.9 ng/mL). Her thyroglobulin levels remained elevated on repeat testing (224.4 ng/mL, n2.8-40.9) one month later. In addition, her thyroglobulin lab studies were repeated with HAMA treatment and remained elevated (277.7 ng/mL, n2.8-40.9). Office ultrasound showed longest dimension of nodule to be 5 cm and patient received FNA biopsy. Biopsy results were reported as a benign nodule and it was recommended to follow-up in 12 months. Six months later the patient reported having increasing dysphagia. She underwent Barium swallow which showed no abnormalities. She had a growth increase of 35% on repeat imaging along with increasing neck pressure and discomfort and was referred to an ENT for surgery. Final pathology after left thyroid and isthmus thyroidectomy was reported as “Multinodular hyperplasia with background thyroid parenchyma histologically unremarkable. Negative for malignancy.” Thyroglobulin levels subsequently returned to within the normal range and the patient’s dysphagia resolved. Conclusion: Thyroglobulin levels can be markedly elevated with benign thyroid nodules, which can mislead physicians and increase concern for thyroid cancer. References: (1) Spencer, CA, Wang, CC. Thyroglobulin measurement. Techniques, clinical benefits, and pitfalls. Endocrinol Metab Clin North Am. 1995 Dec; 24(4): 841-63. (2) Chinnappa, P, Taguba, L, Arciaga, R, Faiman, C, Siperstein, A, Mehta, AE, Reddy SK, Nasr, C, Gupta MK. Detection of thyrotropin-receptor messenger ribonucleic acid (mRNA) and thyroglobulin mRNA transcripts in peripheral blood of patients with thyroid disease: sensitive and specific markers for thyroid cancer. J Clin Endocrinol Metab. 2004 Aug;89(8):3705-9.

scholarly journals Efficacy and safety of radiofrequency ablation for benign thyroid nodules in patients with previous thyroid lobectomy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lin Yan ◽  
Mingbo Zhang ◽  
Fang Xie ◽  
Jun Ma ◽  
Jing Xiao ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Symptom Score ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Efficacy And Safety ◽  
Thyroid Lobectomy ◽  
The Mean ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Background Radiofrequency ablation (RFA) is recommended for the treatment of benign thyroid nodules. However, data on the clinical role of RFA for benign thyroid nodules in patients with history of thyroid lobectomy are insufficient. The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation (RFA) for benign thyroid nodules in patients who had previously undergoing thyroid lobectomy. Methods From May 2015 to October 2018, a total of 20 patients (19 females, 1 male, mean age 49.50 ± 14.26 years, range 22–74 years) with 20 benign thyroid nodules (mean volume 15.04 ± 21.17 ml, range 0.40–69.67 ml) who had undergone previous thyroid lobectomy were included in this retrospective study. Patients were followed up at 3, 6, 12 months after RFA and every 12 months thereafter by ultrasound, clinical evaluation and thyroid function. Volume, volume reduction rate (VRR), symptom score and cosmetic score were evaluated. Results During the mean follow-up time of 21.24 ± 16.41 months, the mean nodule volume decreased significantly from 15.04 ± 21.17 ml to 1.29 ± 1.17 ml (P = 0.018) with a mean VRR of 85.41 ± 12.17%. Therapeutic success was achieved in a single session for all thyroid nodules. The symptom score (P = 0.001) and cosmetic score (P = 0.001) were both significantly reduced at the last follow-up. The levels of free triiodothyronine (fT3), free thyroxine (fT4) and thyroid stimulating hormone were not significantly different at the last follow-up from those prior to treatment (all P > 0.05). No life-threatening complications or sequelae occurred after RFA. Conclusions As a minimally invasive modality, RFA was a safe, effective, and thyroid function-preserving option for patients with symptomatic benign thyroid nodules after a previous lobectomy.

scholarly journals Reproducibility of Ablated Volume Measurement Is Higher with Contrast-Enhanced Ultrasound than with B-Mode Ultrasound after Benign Thyroid Nodule Radiofrequency Ablation—A Preliminary Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1504 ◽  
Author(s):  
Simone Schiaffino ◽  
Francesca Serpi ◽  
Duccio Rossi ◽  
Valerio Ferrara ◽  
Ciriaco Buonomenna ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Nodules ◽  
Observer Agreement ◽  
Contrast Enhanced Ultrasound ◽  
Limits Of Agreement ◽  
Contrast Enhanced ◽  
The Mean ◽  
Preliminary Study ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

The reproducibility of contrast-enhanced ultrasound (CEUS) and standard B-mode ultrasound in the assessment of radiofrequency-ablated volume of benign thyroid nodules was compared. A preliminary study was conducted on consecutive patients who underwent radiofrequency ablation (RFA) of benign thyroid nodules between 2014 and 2016, with available CEUS and B-mode post-ablation checks. CEUS and B-mode images were retrospectively evaluated by two radiologists to assess inter- and intra-observer agreement in the assessment of ablated volume (Bland–Altman test). For CEUS, the mean inter-observer difference (95% limits of agreement) was 0.219 mL (-0.372–0.809 mL); for B-mode, the mean difference was 0.880 mL (-1.655–3.414 mL). Reproducibility was significantly higher for CEUS (85%) than for B-mode (27%). Mean intra-observer differences (95% limits of agreement) were 0.013 mL (0.803–4.097 mL) for Reader 1 and 0.031 mL (0.763–3.931 mL) for Reader 2 using CEUS, while they were 0.567 mL (-2.180–4.317 mL, Reader 1) and 0.759 mL (-2.584–4.290 mL, Reader 2) for B-mode. Intra-observer reproducibility was significantly higher for CEUS (96% and 95%, for the two readers) than for B-mode (21% and 23%). In conclusion, CEUS had higher reproducibility and inter- and intra-observer agreement compared to conventional B-mode in the assessment of radiofrequency-ablated volume of benign thyroid nodules.

scholarly journals Management of bleeding associated with radiofrequency ablation of benign thyroid nodules

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093752
Author(s):  
Kunpeng Hu ◽  
Yufan Lian ◽  
Jinfen Wang ◽  
Wenchao Li ◽  
Zhicheng Yao ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Nodules ◽  
Effective Management ◽  
Voice Change ◽  
Life Threatening ◽  
The Mean ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid ◽  
Clinical Strategy

Objective This study was performed to explore the effective management of bleeding associated with radiofrequency ablation (RFA) of benign thyroid nodules. Methods Thirty-five patients with benign thyroid nodules who were treated with ultrasound-guided RFA from July 2015 to December 2016 at the Third Affiliated Hospital of Sun Yat-sen University were retrospectively reviewed. The technique efficacy, bleeding, and other complications were assessed during the follow-up period. Results The mean technique efficacy was 55.6%±22.8% at 1 month and 24.1%±17.1% at 6 months after the procedure. One case of an intranodular haematoma and two cases of voice change (>1 month) were observed. All patients recovered with corresponding treatment. Conclusion Although the incidence of haemorrhage is low, serious haematomas are life-threatening. Therefore, having a comprehensive understanding of the potential complications, an accurate clinical strategy, and adequate technical skills may prevent or help to properly manage these complications.

A gene expression signature that distinguishes malignant from benign thyroid nodules.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21011-e21011
Author(s):  
Song Tian ◽  
John DiCarlo ◽  
Jiaye Yu ◽  
George J Quellhorst ◽  
Raymond K Blanchard ◽  
...  
Keyword(s):  
Gene Expression ◽  
Random Forest ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Gene Expression Signature ◽  
Support Vector ◽  
Data Set ◽  
Expression Signature ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

e21011 Background: Thyroid nodules can be detected in as high as 67% of the population. Distinguishing thyroid cancers from benign lesions is crucial for determining an appropriate treatment plan. For years a gene expression signature for discriminating malignant from benign thyroid nodules has been sought by clinicians. In this study, multivariate bioinformatics tools were used to generate a qPCR based gene expression signature for determining malignancy in thyroid nodules. Methods: Multiple mathematical models, such as Random Forest, Support Vector Machine (SVM), and Nearest Shrunken Centroid (NSC), were used to analyze published microarray data sets and select 366 putative classifier (biomarker) mRNA targets. The selected 366 genes were further evaluated for their expression pattern by real-time PCR using a panel of 49 pathology assessed thyroid nodule samples (fresh frozen, 23 malignant and 26 benign). Results: Using the qPCR data set, Random Forest was compared with SVM and NSC classifier methods and was found to be more successful in finding genes with better discriminative powers. A Random Forest method identified a panel of 7 genes together with 5 reference genes as a gene expression signature for thyroid malignancy, which led to the development of a companion classifying algorithm to provide a probability score to assess malignancy of thyroid nodules. In our limited sample set, this signature was shown to distinguish malignant and benign thyroid nodules with 92% accuracy and 100% specificity. Conclusions: Our results suggest that a combination of multiple bioinformatics analysis tools is the proper approach for biomarker candidate selection from high-throughput gene expression data. As demonstrated here, panel of 12 genes and a companion classification algorithm has the potential to successfully discriminate malignant thyroid nodule with high accuracy and specificity. This panel of twelve genes is for molecular biology applications only.

scholarly journals Homa-Ir Insulin Resistance in Differentiated Thyroid Cancer and Benign Thyroid Nodules

2021 ◽  
Author(s):  
Eloisa Castillo-Saavedra ◽  
Juan José Castillo-Dávila ◽  
Dania Lizet Quintanilla-Flores ◽  
Anally Jamile Soto-García
Keyword(s):  
Insulin Resistance ◽  
Thyroid Cancer ◽  
Thyroid Nodule ◽  
Differentiated Thyroid Cancer ◽  
Thyroid Nodules ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Benign Thyroid Nodule ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

Abstract Introduction: There is evidence that insulin resistance is associated with different types of cancer. This resistance increases the incidence of benign thyroid nodules and the risk of developing Differentiated Thyroid Cancer, however, studies in this regard are required. Objective: To assess if there are differences in the prevalence of insulin resistance in patients with differentiated thyroid cancer and patients with benign thyroid nodule. Material and methods: Prospective, analytical and cross-sectional design study. Patients undergoing thyroidectomy and definitive diagnosis of differentiated thyroid cancer or benign thyroid nodule were included. Anthropometric and biochemical variables were evaluated and differences in prevalence of insulin resistance were identified. To compare continuous variables, Student's T or Mann Whitney's U was used. To evaluate differences in categorical variables, the two-sided Fisher test when two binary variables were contrasted and Pearson's X2 in variables with more than two categories. Factors were analyzed through multivariate analysis obtaining odds ratio and 95% confidence interval.Results: A lower possibility of cancer was concluded: hereditary-family history of thyroid disease and hypothyroidism (OR 0.159; 95% CI 0.038-0.669; p = 0.012). Positive HOMA-IR showed a significant association in residual structural disease (P = 0.050) and local vascular invasion (p = 0.014).Conclusions: No significant association was obtained between positive HOMA-IR and Differentiated Thyroid Cancer, compared with the Benignity group. It seems that there is a greater tendency to lack of structural and biochemical resolution in patients with malignancy and positive HOMA-IR.

The Place of Elastography in Evaluating the Efficacy of Radiofrequency Ablation of Thyroid Nodules

2017 ◽  
Vol 83 (11) ◽  
pp. 1228-1234
Author(s):  
Ufuk O. Idiz ◽  
Erhan Aysan ◽  
Leyla Elmas ◽  
Seyma Yildiz ◽  
Huseyin Akbulut
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Nodule ◽  
Inverse Relationship ◽  
Thyroid Nodules ◽  
Thyroid Tissue ◽  
Sternocleidomastoid Muscle ◽  
Normal Thyroid Tissue ◽  
Normal Thyroid ◽  
The Mean ◽  
The Relationship

The usage of radiofrequency ablation (RFA) therapy and elastography to treat thyroid nodules has been increasing recently. Elastography specifically measures the stiffness of tissue using ultra-sonography (US). The aim of the present study was to evaluate the relationship between the elastography values of thyroid nodules and the efficacy of RFA therapy. Ultrasonography was performed on 49 patients who had a thyroid nodule with a diameter of 1 cm or greater before RFA therapy. The RFA was performed under local anesthesia, and elastography was used to measure the stiffness of the normal thyroid tissue, sternocleidomastoid muscle (SCM) and thyroid nodules three months after RFA. The nodule diameter significantly decreased three months after RFA (P < 0.05). According to a cross-evaluation of the mean elastography rates, the thyroid/SCM and nodule/thyroid elastography rates had an inverse relationship (P: 0.009). However, the thyroid/ SCM elastography rates and nodule/SCM elastography rates (P: 0.022) and the thyroid/SCM elastography rates and the rates of reduction (%) of the nodule diameter before and three months after RFA (P: 0.016) had positive relationships. In conclusion, RFA therapy is more effective in patients with thyroid nodules if there are high thyroid tissue/SCM rates in elastography.

Diagnostic Value of Acoustic Radiation Force Impulse Quantification in the Differentiation of Benign and Malignant Thyroid Nodules

2017 ◽  
Vol 39 (5) ◽  
pp. 326-336 ◽  
Author(s):  
Niraj Nirmal Pandey ◽  
Gaurav Shanker Pradhan ◽  
Alpana Manchanda ◽  
Anju Garg
Keyword(s):  
Thyroid Nodules ◽  
Acoustic Radiation ◽  
Radiation Force ◽  
Acoustic Radiation Force ◽  
Ultrasound Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Shear Wave Speed ◽  
The Mean ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

The objective of this study was to evaluate the role of ultrasound elastography using acoustic radiation force impulse (ARFI) quantification in characterizing and differentiating malignant versus benign thyroid nodules. A total of 40 thyroid nodules were evaluated with conventional sonography and ultrasound elastography using ARFI quantification. The final diagnosis was obtained from histologic findings. A total of 14 malignant and 26 benign nodules were diagnosed on the basis of histologic examination. Majority of the malignant thyroid nodules demonstrated presence of intranodular vascular flow, hypoechoic echotexture, absent halo, irregular margins and microcalcifications. However, a considerable overlap was noted in the sonographic features of malignant and benign thyroid nodules. On ARFI quantification, the mean shear wave speed (SWS) values ( M ± SD) of malignant and benign thyroid nodules were 3.131 ± 0.921 m/s and 1.691 ± 0.513 m/s, respectively. A significant difference was observed between the mean SWS values of malignant thyroid nodules and benign thyroid nodules ( p < 0.0001). Applying a cutoff value of 2.53 m/s, the sensitivity, specificity, and the area under the receiver operating characteristic curve for the differentiation were 85.71%, 96.15%, and 0.922, respectively. ARFI quantification is a promising elastography technique that provides quantitative information about tissue stiffness. It provides additional information and complements sonography as an effective diagnostic tool in characterizing and differentiating benign from malignant thyroid nodules.

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