Change of serum anti-thyroglobulin antibody levels is useful for prediction of clinical recurrence in thyroglobulin negative pat

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Change of Serum Anti-Thyroglobulin Antibody Levels Is Useful for Prediction of Clinical Recurrence in Thyroglobulin Negative Patients with Differentiated Thyroid Carcinoma.
J Clin Endocrinol Metab. 2008 Sep 23;
Authors: Kim WG, Yoon JH, Kim WB, Kim TY, Kim EY, Kim JM, Ryu JS, Gong G, Hong SJ, Shong YK
Objectives: To evaluate the usefulness of the anti-thyroglobulin autoantibody (TgAb) value at 6 -12 months after remnant ablation in predicting recurrence in differentiated thyroid carcinoma (DTC) patients who had undetectable thyroglobulin (Tg) values. The change in TgAb concentration measured between the time of remnant ablation (TgAb1) and 6 -12 months thereafter (TgAb2) was also evaluated as a possible prognostic indicator. Patients and methods: Patients with DTC who underwent total thyroidectomy followed by (131)I remnant ablation between 1995 and 2003 at the Asan Medical Center, Seoul, Korea, were enrolled. Of these, 824 patients with undetectable Tg at 6 -12 months after remnant ablation during thyroid hormone withdrawal were the subjects of this study. Results: TgAb2 was positive in 56 patients. Ten of 56 patients (18%) with positive TgAb2 had recurrence whereas only 10 of 768 patients (1%) with negative TgAb2 had recurrence during 73.6 months of follow-up (p<0.001). The change between TgAb1 and TgAb2 levels was evaluated in patients with positive TgAb2. TgAb concentration decreased by more than 50% in 21 patients (group 1), by less than 50% in 16 patients (group 2), and increased in 19 patients (group 3). The recurrence rates in groups 1, 2, and 3 were 0%, 19%, and 37%, respectively (p=0.016). Conclusions: Serum TgAb levels measured at 6 -12months after remnant ablation could predict recurrence in patients with undetectable Tg values. In patients with undetectable Tg and positive TgAb values, a change in TgAb concentration during the early post-operative period may be a prognostic indicator of recurrence.
PMID: 18812478 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)