REVIEW  UPDATE ON THE DIAGNOSIS AND TREATMENT OF DIFFERENTIATED THYROID CANCER 

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2009 October;53(5):482-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Serum thyroglobulin measurement in the follow-up of patients treated for differentiated thyroid cancer

Zucchelli G. ¹, Iervasi A. ¹, Ferdeghini M. ², Iervasi G. ¹ ✉

¹ CNR of Clinical Physiology, Pisa, Italy; ² Nuclear Medicine University of Verona, Verona, Italy

Determination of thyroglobulin (Tg) in serum represents a key element in the follow-up of patients treated for differentiated thyroid cancer (DTC). The sensitivity and the specificity of the assay strongly affects the clinical impact. Most of patients are disease-free after thyroidectomy and iodine radioablation; 15% of them show over time persistent or recurrent disease; of these, 5% dies due to worsening of disease. This implies that the follow-up procedures should have a high negative predictive value to reduce as possible the unnecessary diagnostic tools and a high positive predictive value to identify the few patients with persistent/recurrent disease. The recent international guidelines are based on thyroglobulin measurement after thyroid-stimulating hormone (TSH) stimulation. More recent studies suggest that follow up based on serial measurements of basal (i.e. unstimulated) Tg show a higher predictive value than the single measurement after stimulation. Large and multicenter studies are necessary to modify the current guidelines.