Serum antithyroglobulin antibody levels are not a good predictive factor on detection of disease activity in patients with papillary thyroid carcinoma

AbstractThe clinical outcome of papillary thyroid carcinoma (PTC) patients with an indeterminate response after initial therapy is reported to be intermediate, between incomplete and excellent responses. This study evaluated the outcomes of PTC patients with indeterminate response after initial therapy. It was further determined whether the indeterminate findings predicted outcomes more precisely. Patients were further classified into 3 groups based on risk of structural persistence/recurrence: Tg group: detectable thyroglobulin, negative antithyroglobulin antibody, regardless nonspecific imaging findings; TgAb group: positive antithyroglobulin antibody, regardless thyroglobulin levels and nonspecific imaging findings, and Image group: nonspecific findings on neck ultrasonography or faint uptake in the thyroid bed on whole-body scan, undetectable thyroglobulin and negative antithyroglobulin antibody. Sixty-six patients aged 44.1±12.7 years were studied, of whom 58 (87.9%) were females. All patients underwent total thyroidectomy, and 52 patients (78.8%) received radioiodine. After 5.7 years (P25–75 2.6–9.75 years) of follow-up, most patients (89.4%) were reclassified as having an excellent response or remained in the indeterminate response to therapy. Structural recurrence/persistence disease was detected in 7 (10.6%) patients. The persistence/recurrence rate in groups were as follow: Tg, 2.63%; TgAb, 31.25%; Image, 8.3% (p=0.007). The 10-years disease-free survival rate in the TgAb group was significantly reduced (p=0.022). Our results suggest that patients with PTC and indeterminate response due to positive serum antithyroglobulin antibody have more risk of development of structural disease. These findings suggest a more individualized follow-up strategy for patients with an indeterminate response.

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Impact of co-existent thyroiditis on clinical outcome in papillary thyroid carcinoma with high preoperative serum antithyroglobulin antibody: a retrospective cohort study

Clinical Otolaryngology ◽

10.1111/coa.12520 ◽

2016 ◽

Vol 41 (4) ◽

pp. 358-364 ◽

Cited By ~ 4

Author(s):

H.-Y. Nam ◽

H.Y. Lee ◽

G.C. Park

Keyword(s):

Cohort Study ◽

Papillary Thyroid Carcinoma ◽

Clinical Outcome ◽

Thyroid Carcinoma ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Papillary Thyroid ◽

Antithyroglobulin Antibody ◽

Preoperative Serum

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Level V Metastasis, a Novel Predicative Factor for Recurrence in N1b Papillary Thyroid Carcinoma

Current Pharmaceutical Design ◽

10.2174/1381612823666171009150320 ◽

2018 ◽

Vol 24 (5) ◽

pp. 559-563

Author(s):

Yifeng Wu ◽

Jianjun Li ◽

Xianjiang Wu ◽

Lei Dai

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Predictive Factor ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Rank Test ◽

Papillary Thyroid ◽

Poor Prognostic Factor ◽

Log Rank Test ◽

Kaplan Meier

Background: Lymph nodal (LN) metastasis, classified as pN1b, is considered as an independent poor prognostic factor for Papillary thyroid carcinoma (PTC) patients. However, whether LN metastasis can serve as a predictive factor for recurrence or disease-free survival of N1b PTC is still plagued by controversy. Methods: The N1b PTC patients who underwent total thyroidectomy and unilateral modified radical neck dissection (MRND) by the same surgical team in Ningbo NO.2 Hospital from March, 1998 to March, 2015 were included in this study. The clinical and pathological characteristics of each patient were recorded in detail. Univariate and multivariate Cox proportional hazards regression models were performed to analyze the associations between clinicopathological characteristics with recurrence. Kaplan–Meier analysis and log-rank test were used for the analysis of overall RFS and level V metastasis. Results: A total of 214 patients were eligible for the final analyses. Of the 214 finally included patients with N1b PTC, 39 patients were classified with recurrence and 175 without recurrence. The final univariate and multiple Cox proportional hazards analysis only suggested level V metastasis as the independent predictive factor of N1b PTC recurrence (HR: 4.11; 95% CI:1.22–11.05, P=0.028). The patients with level V metastasis showed a significantly lower 10-year RFS rate (P=0.031) as illustrated by Kaplan–Meier analysis and log-rank test. Conclusion: Level V metastasis is a novel indicator for tumor recurrence and 10-year RFS in patients with N1b PTC.

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