Skip to main content
SpringerLink
Log in

Prognostic value of change in anti-thyroglobulin antibodies after thyroidectomy in patients with papillary thyroid carcinoma

  • Research Article
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Purpose

Anti-thyroglobulin antibodies (TgAb) can be used as a surrogate tumor marker in the follow-up of papillary thyroid carcinoma (PTC). We try to determine if the change in TgAb levels in the first post-operative year is a good predictor of persistence/recurrence risk in TgAb-positive PTC patients.

Methods/patients

105 patients with PTC who underwent thyroidectomy between 1988 and 2014 were enrolled. We calculated the percentage of change in TgAb levels with the first measurement at 1–2 months after surgery and the second one at 12–14 months.

Results

TgAb negativization was observed in 29 patients (27.6%), a decrease of more than 50% was observed in 57 patients (54.3%), less than 50% in 12 patients (11.4%) and in 7 patients (6.7%) the TgAb level had increased. The percentage of persistence/recurrence was 0, 8.8, 16.7 and 71.4% in each group, respectively (p < 0.001). In the multivariate analysis, only the percentage of change in TgAb showed a significant association with the risk of persistence/recurrence, regardless of other factors such as age, size and TNM stages.

Conclusions

Changes in TgAb levels in the first year after surgery can predict the risk of persistence/recurrence of TgAb-positive PTC patients. Patients who achieved negativization of TgAb presented an excellent prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Spencer CA. Editorial: challenges of serum thyroglobulin (Tg) measurement in the presence of Tg autoantibodies. J Clin Endocrinol Metab. 2004;89(8):3702–4.

    Article  CAS  PubMed  Google Scholar 

  2. Demers LM, Spencer CA. Laboratory medicine practice guidelines: laboratory support for the diagnosis and monitoring of thyroid disease. Clin Endocrinol. 2003;58(2):138–40.

    Article  CAS  Google Scholar 

  3. Spencer C, Petrovic I, Fatemi S, LoPresti J. Serum thyroglobulin (Tg) monitoring of patients with differentiated thyroid cancer using sensitive (second-generation) immunometric assays can be disrupted by false-negative and false-positive serum thyroglobulin autoantibody misclassifications. J Clin Endocrinol Metab. 2014;99(12):4589–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133. doi:10.1089/thy.2015.0020.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Medeiros Neto G. Iodine supplementation and thyroid autoimmunity. Clin Endocrinol. 1994;40(3):435.

    Google Scholar 

  6. Pacini F, Mariotti S, Formica N, Elisei R, Anelli S, Capotorti E, et al. Thyroid autoantibodies in thyroid-cancer incidence and relationship with tumor outcome. Acta Endocrinol. 1988;119(3):373–80.

    CAS  PubMed  Google Scholar 

  7. Kumar A, Shah DH, Shrihari U, Dandekar SR, Vijayan U, Sharma SM. Significance of antithyroglobulin autoantibodies in differentiated thyroid-carcinoma. Thyroid. 1994;4(2):199–202.

    Article  CAS  PubMed  Google Scholar 

  8. Spencer CA, Takeuchi M, Kazarosyan M, Wang CC, Guttler RB, Singer PA, et al. Serum thyroglobulin autoantibodies: prevalence, influence on serum thyroglobulin measurement, and prognostic significance in patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab. 1998;83(4):1121–7.

    CAS  PubMed  Google Scholar 

  9. Rubello D, Casara D, Girelli ME, Piccolo M, Busnardo B. Clinical meaning of circulating antithyroglobulin antibodies in differentiated thyroid cancer. A prospective study. J Nucl Med. 1992;33(8):1478–80.

    CAS  PubMed  Google Scholar 

  10. Chung JK, Park YJ, Kim TY, So Y, Kim SK, Park DJ, et al. Clinical significance of elevated level of serum antithyroglobulin antibody in patients with differentiated thyroid cancer after thyroid ablation. Clin Endocrinol. 2002;57(2):215–21.

    Article  Google Scholar 

  11. Gorges R, Maniecki M, Jcntzen W, Sheu SNY, Mann K, Bockisch A, et al. Development and clinical impact of thyroglobulin antibodies in patients with differentiated thyroid carcinoma during the first 3 years after thyroidectomy. Eur J Endocrinol. 2005;153(1):49–55.

    Article  CAS  PubMed  Google Scholar 

  12. Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988–1994): national health and nutrition examination survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489–99.

    Article  CAS  PubMed  Google Scholar 

  13. Qin J, Yu ZQ, Guan HX, Shi LF, Liu YP, Zhao N, et al. High thyroglobulin antibody levels increase the risk of differentiated thyroid carcinoma. Dis Markers. 2015; 2015:648–670.

    Article  Google Scholar 

  14. Kim ES, Lim DJ, Baek KH, Lee JM, Kim MK, Kwon HS, et al. Thyroglobulin antibody is associated with increased cancer risk in thyroid nodules. Thyroid. 2010;20(8):885–91.

    Article  CAS  PubMed  Google Scholar 

  15. Grebe SKG. Thyroglobulin autoantibodies, thyroid nodules, and new insights into some old questions. Thyroid. 2010;20(8):841–2.

    Article  CAS  PubMed  Google Scholar 

  16. Phan HTT, Jager PL, van der Wal JE, Sluiter WJ, Plukker JTM, Dierckx R, et al. The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation. Eur J Endocrinol. 2008;158(1):77–83.

    Article  CAS  PubMed  Google Scholar 

  17. Soyluk O, Boztepe H, Aral F, Alagol F, Ozbey NC. Papillary thyroid carcinoma patients assessed to be at low or intermediary risk after primary treatment are at greater risk of long term recurrence if they are thyroglobulin antibody positive or do not have distinctly low thyroglobulin at initial assessment. Thyroid. 2011;21(12):1301–8.

    Article  CAS  PubMed  Google Scholar 

  18. Kim TY, Kim WB, Kim ES, Ryu JS, Yeo JS, Kim SC, et al. Serum thyroglobulin levels at the time of (131)I remnant ablation just after thyroidectomy are useful for early prediction of clinical recurrence in low-risk patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab. 2005;90(3):1440–5.

    Article  CAS  PubMed  Google Scholar 

  19. Seo JH, Lee SW, Ahn BC, Lee J. Recurrence detection in differentiated thyroid cancer patients with elevated serum level of antithyroglobulin antibody: special emphasis on using 18F-FDG PET/CT. Clin Endocrinol. 2010;72(4):558–63.

    Article  CAS  Google Scholar 

  20. Durante C, Tognini S, Montesano T, Orlandi F, Torlontano M, Puxeddu E, et al. Clinical aggressiveness and long-term outcome in patients with papillary thyroid cancer and circulating anti-thyroglobulin autoantibodies. Thyroid. 2014;24(7):1139–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Chiovato L, Latrofa F, Braverman LE, Pacini F, Capezzone M, Masserini L, et al. Disappearance of humoral thyroid autoimmunity after complete removal of thyroid antigens. Ann Intern Med. 2003;139(5):346–51.

    Article  CAS  PubMed  Google Scholar 

  22. Kim WG, Yoon JH, Kim WB, Kim TY, Kim EY, Kim JM, et al. Change of serum antithyroglobulin antibody levels is useful for prediction of clinical recurrence in thyroglobulin-negative patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab. 2008;93(12):4683–9.

    Article  CAS  PubMed  Google Scholar 

  23. Spencer C, Fatemi S. Thyroglobulin antibody (TgAb) methods—strengths, pitfalls and clinical utility for monitoring TgAb-positive patients with differentiated thyroid cancer. Best Pract Res Clin Endocrinol Metab. 2013;27(5):701–12.

    Article  CAS  PubMed  Google Scholar 

  24. Tsushima Y, Miyauchi A, Ito Y, Kudo T, Masuoka H, Yabuta T, et al. Prognostic significance of changes in serum thyroglobulin antibody levels of pre- and post-total thyroidectomy in thyroglobulin antibody-positive papillary thyroid carcinoma patients. Endocr J. 2013;60(7):871–6.

    Article  CAS  PubMed  Google Scholar 

  25. Yamada O, Miyauchi A, Ito Y, Nakayama A, Yabuta T, Masuoka H, et al. Changes in serum thyroglobulin antibody levels as a dynamic prognostic factor for early-phase recurrence of thyroglobulin antibody-positive papillary thyroid carcinoma after total thyroidectomy. Endocr J. 2014;61(10):961–5.

    Article  CAS  PubMed  Google Scholar 

  26. Hsieh CJ, Wang PW. Sequential changes of serum antithyroglobulin antibody levels are a good predictor of disease activity in thyroglobulin-negative patients with papillary thyroid carcinoma. Thyroid. 2014;24(3):488–93.

    Article  CAS  PubMed  Google Scholar 

  27. Edge SB, Compton CC. The American joint committee on cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471–4.

    Article  PubMed  Google Scholar 

  28. Li C, Yu W, Fan J, Li G, Tao X, Feng Y, et al. Thyroid functional parameters and correlative autoantibodies as prognostic factors for differentiated thyroid cancers. Oncotarget. 2016;7(31):49930–8.

    PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We would like to thank our center for the technical support.

Author information

Authors and Affiliations

  1. Department of Endocrinology, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Navarra, Spain

    A. Ernaga-Lorea, E. Anda-Apiñániz, J. J. Pineda-Arribas, I. Migueliz-Bermejo, N. Eguílaz-Esparza & A. Irigaray-Echarri

  2. Department of Endocrinology, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain

    M. C. Hernández-Morhain

Authors
  1. A. Ernaga-Lorea
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. C. Hernández-Morhain
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Anda-Apiñániz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. J. Pineda-Arribas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. I. Migueliz-Bermejo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. N. Eguílaz-Esparza
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Irigaray-Echarri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Ernaga-Lorea.

Ethics declarations

Funding

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights statement

The research involving human participants are conducted in a way which respects the dignity, rights, and welfare of participants.

Ethical approval

This study was conducted in compliance with ethical principles based on the Declaration of Helsinki and with the approval of the ethics committee of our center. We used anonymous data for the research.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ernaga-Lorea, A., Hernández-Morhain, M.C., Anda-Apiñániz, E. et al. Prognostic value of change in anti-thyroglobulin antibodies after thyroidectomy in patients with papillary thyroid carcinoma. Clin Transl Oncol 20, 740–744 (2018). https://doi.org/10.1007/s12094-017-1782-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-017-1782-3

Keywords

Search

Navigation