Postoperative-stimulated serum thyroglobulin measured at the time of I-131 ablation is useful for the prediction of disease status in patients with differentiated thyroid carcinoma
- Authors
- Lee, Ji In; Chung, Yun Jae; Cho, Bo Youn; Chong, SeMin; Seok, Ju Won; Park, Sung Jun
- Issue Date
- Jun-2013
- Publisher
- MOSBY-ELSEVIER
- Citation
- SURGERY, v.153, no.6, pp 828 - 835
- Pages
- 8
- Journal Title
- SURGERY
- Volume
- 153
- Number
- 6
- Start Page
- 828
- End Page
- 835
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/14589
- DOI
- 10.1016/j.surg.2012.12.008
- ISSN
- 0039-6060
- Abstract
- Background. This study was conducted to identify the relevant cutoff value and to evaluate the usefulness of postoperative-stimulated serum thyroglobulin (Tg) at the time of I-131 ablation for the prediction of disease status in patients with differentiated thyroid carcinoma (DTC) who received high-dose I-131 ablation therapy after total thyroidectomy. Methods. We analyzed 218 consecutively enrolled patients who were diagnosed with DTC and underwent total thyroidectomy. All patients underwent I-131 ablation at. doses of 100-200 mCi, and. stimulated serum Tg was measured ai the time of I-131 ablation therapy. To assess disease-free status after I-131 ablation therapy, stimulated serum Tg levels, diagnostic whole-body scan (DxWBS) and. neck ultrasonography (US) were performed 6-12 months after I-131 ablation. Results. The relevant cutoff value of postoperative stimulated Tg for the prediction of disease-free status was 2 ng/mL. A total of 138 patients (63.3%) showed values of <2 ng/mL. Postoperative-stimulated Tg < 2 ng/mL had a negative piedictive value of 94.9%, which increased to 97.7% when low Tg was combined with negative neck US findings. Conclusion. Postoperative-stimulated Tg at the time of I-131 remnant ablation is a useful biochemical marker for the prediction of disease status in patients with DTC. When high-dose I-131 remnant ablation is performed after total thyroidectOmy, the stimulated Tg measurement and DxWBS that are usually performed 6-12 months after I-131 ablation therapy may be skipped, at least in low- and intermediate-risk patients with postoperative stimulated Tg of < 2 ng/mL and negative neck US findings.
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