| Unstimulated high sensitive thyroglobulin measurement predicts outcome of differentiated thyroid carcinoma. | |
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MedLine Citation:
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PMID: 19589104 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Thyroglobulin (Tg) measurement following thyrotropin (TSH) stimulation is used in the follow-up of patients with differentiated thyroid carcinoma (DTC). However, high-sensitive assays allow accurate measurement of serum Tg even without TSH stimulation. Here, we prospectively evaluated the impact of unstimulated high-sensitive Tg measurement in early and long-term outcome of patients with DTC. METHODS: One hundred and ninety five patients affected with DTC were evaluated. Six months after thyroid ablation (i.e., thyroidectomy plus radioiodine) serum Tg was measured during TSH-suppressive thyroxine (T4) treatment (onT4-Tg). Patients with undetectable onT4-Tg and negative neck ultrasound (US) were considered disease free and onT4-Tg was measured every 12 months for a mean follow-up of 6.8 (4.7-8.9) years. Patients with an increase in onT4-Tg underwent specific diagnostic work-up and appropriate treatment if necessary. RESULTS: Four patients showed recurrence at first follow-up visit with a corresponding increase in onT4-Tg concentrations (sensitivity 100%). Three patients had false positive onT4-Tg measurement (specificity 98%) with a spontaneous decrease within 3-6 months in all cases (specificity 100%). Three of 188 patients with undetectable serum onT4-Tg at first follow-up showed recurrence later with an increase in onT4-Tg as the first (n=2) or unique (n=1) sign of relapse (sensitivity 100%). Among 185 disease-free patients in a prolonged follow-up, 12 had a transient increase in onT4-Tg (specificity 91.6%). However, a spontaneous reduction within 3-6 months occurred in all cases (specificity 100%). CONCLUSIONS: Undetectable serum onT4-Tg using a high-sensitivity immunoradiometric assay 6 months after thyroid ablation predicts low-risk of DTC recurrence. When onT4-Tg became detectable during follow-up, the evaluation of Tg slope in a 3-6 months period accurately discriminated patients with DTC recurrence from those without recurrence. This helped avoid unnecessary diagnostic or therapeutic procedures. |
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Authors:
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Luca Giovanella; Marco Maffioli; Luca Ceriani; Diego De Palma; Giuseppe Spriano |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical chemistry and laboratory medicine : CCLM / FESCC Volume: 47 ISSN: 1434-6621 ISO Abbreviation: Clin. Chem. Lab. Med. Publication Date: 2009 |
Date Detail:
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Created Date: 2009-07-31 Completed Date: 2009-10-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9806306 Medline TA: Clin Chem Lab Med Country: Germany |
Other Details:
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Languages: eng Pagination: 1001-4 Citation Subset: IM |
Affiliation:
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Department of Nuclear Medicine, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. luca.giovanella@eoc.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Carcinoma / blood*, radiotherapy, surgery Female Humans Immunoradiometric Assay Male Middle Aged Neoplasm Recurrence, Local / blood, diagnosis* Prospective Studies Thyroglobulin / blood* Thyroid Neoplasms / blood*, radiotherapy, surgery Thyrotropin / administration & dosage Thyroxine / therapeutic use |
| Chemical | |
Reg. No./Substance:
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7488-70-2/Thyroxine; 9002-71-5/Thyrotropin; 9010-34-8/Thyroglobulin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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