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A Journal on Endocrine System Diseases

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Minerva Endocrinologica 2009 September;34(3):195-203


language: English

Prevalence, clinical significance and prognostic value of anti-thyroglobulin antibodies in the follow-up of patients with differentiated thyroid carcinoma: a retrospective study

Pedrazzini L. 1, Baroli A. 1, Lomuscio G. 1, Marzoli L. 2

1 Nuclear Medicine Unit, Circolo Hospital, Busto Arsizio, Varese, Italy 2 Sanitary Physics Unit, Circolo Hospital, Busto Arsizio, Varese, Italy


AIM: Elevated persistent value of antithyroglobulin antibodies (Ab-Tg) in differentiated thyroid carcinoma (DTC) patients may interfere with Tg determination. The aim of the study was to evaluate the use of Ab-Tg as tumor marker as a replacement for thyroglobulin (Tg).
METHODS: From 1990 al 2004 767 patients have been treated and followed, mean follow-up years 6.9±2.4. Thirty-two patients Ab-Tg positive after radioiodine ablation, who had showed during the follow-up stable indosable value di Tg, have undergone analysis.
RESULTS: The recurrences were statistically more significant when Ab-Tg were increased, than when Ab-Tg were stable or diminished during the time (P<0.0001). Lymphocytic thyroditis was found in thirteen patients (40.6%) at histological specimen after thyroidectomy. The persistence of lymphocytic thyroditis has not modified the value of Ab-Tg as tumor marker (P<0.001). The 10/32 (31.2%) patients Tg negative have been compared to the 61/712 patients Ab-Tg positive (8.6%) who relapse. The recurrence rate was significantly higher for the first group of patients than that for the second (P<0.0001). Multivariate analisys showed N1 (P<0.001; OR 2.51) and Ab-Tg positive (P<0.001; OR: 6.15) associated with recurrences.
CONCLUSIONS: Ab-Tg must be determined, in concomitance with Tg, during the follow-up of DTC, to establish the accuracy of Tg, in order to use it as tumour marker. It must be kept in mind that the strongest indication for relapse due to Ab-Tg is an increasing of level in the same patient measured in the long time. Persistent elevated Ab-Tg levels are prognostic of future recurrences.

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