Abstract
Objectives:In this study, we aimed to investigate the predictive value of pre-ablative stimulated thyroglobulin (Tg) and Tg/thyroid-stimulating hormone (TSH) to identify lymph node metastasis (LNM) or distant metastases (DM) prior to radioactive iodine (RAI) treatment.Methods:Patients without metastasis were included in group 1 (n=100), those with LNM were included in group 2 (n=83), and those with DM constituted group 3 (n=23). Tg and TSH values were measured approximately 4 hours prior to RAI ablation therapy.Results:There was a significant difference between group 3 and other groups (group 1 and group 2) in terms of Tg (p<0.001) and Tg/ TSH (p<0.001). For Tg level and Tg/TSH ratio, the areas under ROC were 0.990 [95% confidence interval (CI): 0.979-1] and 0.991 (95% CI: 0.981-1), respectively. The cut-off points for Tg and Tg/TSH were 102 ng/mL and 1.06, respectively.Conclusion:Our results suggest that Tg and Tg/TSH values can be used to predict DM. On the other hand, our study indicates that patients should be carefully evaluated for LNM even when Tg levels are low.
Highlights
Thyroid cancer is the most common endocrine malignancy worldwide, with a rapidly inceraseing incidence rate [1]
Tg levels significantly decrease after surgical removal of thyroid tissue, while Tg levels remain high in case of residual tissue or distant metastases (DM) in thyroid cancer [7]
One hundred patients without metastasis were included in group 1, eighty-three patients with lymph node metastasis were included in group 2 and 23 patients with DM were included in group 3
Summary
Thyroid cancer is the most common endocrine malignancy worldwide, with a rapidly inceraseing incidence rate [1]. The standard treatments for DTC include total thyroidectomy (TT), radioactive iodine (RAI) ablation therapy (patients with a tumor >1 cm in size) and long-term thyroid stimulating hormone (TSH) suppression therapy [2]. LNM or DM can be detected by using clinical evaluation, as well as surgical, radiological and diagnostic iodine-131 (I-131) whole-body scan (WBS) findings. It will be more appropriate if diagnostic tools are performed after a risk assessment or clinical suspicion. Endogenous TSH can stimulate Tg release from the thyroid bed or metastatic tissue. Endogenous TSH induce Tg release from thyroid bed or metastatic tissue. The aim of this study was to investigate the potential value of pre-ablative stimulated Tg and Tg/TSH to identify LNM or DM prior to RAI treatment
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