Document Detail

Sequential follow-up of serum thyroglobulin and whole body scan in thyroid cancer patients without initial metastasis.
MedLine Citation:
PMID:  17199438     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the usefulness of whole body scan (WBS) and serum thyroglobulin (Tg) measurement after thyroxine withdrawal during sequential follow-ups in patients with differentiated thyroid cancer (DTC). DESIGN: Two hundred and sixty-five consecutive DTC patients were enrolled. They were previously treated with near-total thyroidectomy and I-131 remnant ablation, without initial metastases or Tg antibodies. All had the first follow-up WBS and serum Tg measurement 6-12 months after initial treatment, and 165 patients received the second follow-up without further therapy. Positive/negative predictive values (PPV/NPV) were calculated by the outcome of patients being followed up for more than 8 years (mean+/-SD: 133+/-26 months). RESULTS: Serum Tg levels while the patients were off thyroxine therapy decreased spontaneously in 39.3% of the cases without further therapy. The NPV of the first follow-up serum Tg level was excellent: <2 microg/L and <0.5 microg/L were 95.1% and 98.2%, respectively. However, the PPV of the first follow-up serum Tg level was low: >10 microg/L and 2-10 microg/L were 40% and 9.6%, respectively. The trend of Tg levels was more informative; the PPV was 62.5% in cases with an increase of serum Tg of >10 microg/L and 16.6% with an increase of <5 microg/L. However, decreasing Tg levels may associate with rapid deterioration of disease, in which cases decrease of Tg indicated dedifferentiation of the tumor. The diagnostic WBS showed the same picture in 91.5% of the patients. Only one patient (0.6%) turned from negative study to positive during the follow-up. In the meanwhile his serum Tg levels increased from 0.56 to 13.6 microg/L. CONCLUSION: It is most informative when both the trend and the levels of Tg during sequential follow-up are considered. The diagnostic WBS may be performed for selected patients with indication based on Tg levels to localize the disease.
Shu-Hua Huang; Pei-Wen Wang; Yu-Erh Huang; Fong-Fu Chou; Rue-Tsuan Liu; Shih-Chen Tung; Jung-Fu Chen; Ming-Chun Kuo; Jing-Rong Hsieh; Hsin-Hung Hsieh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  16     ISSN:  1050-7256     ISO Abbreviation:  Thyroid     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-01-03     Completed Date:  2007-02-20     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1273-8     Citation Subset:  IM    
Department of Nuclear Medicine, Chang Gung Memorial Hospital-Ksohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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MeSH Terms
Carcinoma, Papillary / radionuclide imaging*,  therapy
Follow-Up Studies
Middle Aged
Neoplasm Metastasis / radionuclide imaging
Predictive Value of Tests
Substance Withdrawal Syndrome
Thyroglobulin / blood*
Thyroid Neoplasms / radionuclide imaging*,  therapy
Thyroxine / therapeutic use
Whole Body Imaging*
Reg. No./Substance:
7488-70-2/Thyroxine; 9010-34-8/Thyroglobulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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