Serial Measurements of Off-Thyroxine Serum TSH and Thyroglobulin Levels to Predict Local and/or Systemic Metastasis of Papillary Thyroid Cancer after Total ThyroidectomySerial Measurements of Off-Thyroxine Serum TSH and Thyroglobulin Levels to Predict Local and/or Systemic Metastasis of Papillary Thyroid Cancer after Total Thyroidectomy
- Other Titles
- Serial Measurements of Off-Thyroxine Serum TSH and Thyroglobulin Levels to Predict Local and/or Systemic Metastasis of Papillary Thyroid Cancer after Total Thyroidectomy
- Authors
- 이정원; 김선형; 이상아; 고관표; 이상미; 이대호
- Issue Date
- 2012
- Publisher
- 대한갑상선학회
- Keywords
- Thyroid cancer; Thyroglobulin; TSH
- Citation
- International Journal of Thyroidology, v.5, no.2, pp.148 - 156
- Journal Title
- International Journal of Thyroidology
- Volume
- 5
- Number
- 2
- Start Page
- 148
- End Page
- 156
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/15582
- ISSN
- 2384-3799
- Abstract
- Background and Objectives: Off-thyroxine serum thyroglobulin (Tg) level is important to predict metastatic disease (MD) in papillary thyroid cancer (PTC); however, it is unclear whether a single off-thyroxine Tg level is sufficient for predicting MD. In this study, we determined whether serial measurement of off-thyroxine serum Tg level can predict metastasis in PTC patients after total thyroidectomy. Materials and Methods: We enrolled 140 PTC patients in whom serum thyroid-stimulating hormone (TSH) and Tg levels were measured 7 days before radio-iodine (RAI) treatment (TSHA and TgA) and on the day of RAI treatment (TSHB and TgB) with withholding L-thyroxine for 4 weeks before RAI treatment. The values of TSHinc (TSHB-TSHA) and Tginc (TgB-TgA), Tgratio (TgB/TgA),Tginc/TSHinc and Tgratio/TSHinc were calculated. Tginc/TSHinc and Tgratio/TSHinc were tested if those parameters can predict MD in patients with TSHA>30 μIU/mL and TgA<10 ng/mL. Results: Forty-four patients had MD and 96had no evidence of MD (non-MD). MD group showed higher levels of TgA, TgB, Tginc, Tginc/TSHinc and Tgratio/TSHinc compared with non-MD group. A significant correlation was found between TSHinc and Tgratio (r=0.669) in MD group. In 43 patients with TSHA>30 μIU/mL and TgA<10 ng/mL (MD, 9; non-MD, 34), both Tginc/TSHinc (100%)and Tgratio/TSHinc (89%) had higher sensitivities for predicting MD than TgB (78%). Conclusion: With the increment in serum Tg corrected for the increment in serum TSH, serial measurements of off-thyroxine serum TSH and Tg levels can help predict PTC metastasis.
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