Abstract
Background
Thyroglobulin antibody(TgAb) was generally used as a prognostic marker of papillary thyroid cancer(PTC) only after total thyroidectomy, but its value in PTC patients with concomitant Hashimoto’s thyroiditis(HT) is unclear. We aimed to assess the prognostic significance of the serum TgAb in these patients.
Methods
This retrospective cohort study included PTC patients and pathologically proven HT from 2007–2016. The Cox proportional hazards model with restricted cubic spline was used to analyze the association between TgAb and structural recurrence, and then survival analysis was performed.
Results
Of 839 patients enrolled, 48 recurrences were identified during a median follow-up of 64 months. Macrocarcinoma and lymph node metastasis were significantly associated with higher TgAb (P = 0.006, 0.002), but no significant difference was found for any other characteristics. An increasing preoperative TgAb level up to 2000 IU/ml was associated with shorter recurrence-free survival(RFS) (P < 0.001), and the 5-year RFS rates in patients with TgAb ≤400, 400–800 and >800 IU/ml were 97.3%, 93.2% and 85.8%, respectively (P < 0.05). The difference was found even after adjusting for potential risk factors (P < 0.001). Of 337 PTC patients who were treated with lobectomy and had available TgAb data at the first year after surgery, a significant decrease (≥50%) in postoperative TgAb was achieved in 41.8% patients, who had a favorable prognosis compared with others (5-year RFS rate 98.5% vs. 92.0%, P = 0.008).
Conclusions
The preoperative serum TgAb seem to effectively stratify PTC patients with concomitant HT who had high risk for recurrence, and the early postoperative trends of TgAb was a good prognostic marker for these patients who treated with lobectomy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
J.H. Lee, Y. Kim, J.W. Choi et al. The association between papillary thyroid carcinoma and histologically proven Hashimoto’s thyroiditis: a meta-analysis. Eur. J. Endocrinol. 168(3), 343–349 (2013)
H. Baser, D. Ozdemir, N. Cuhaci et al. Hashimoto’s thyroiditis does not affect ultrasonographical, cytological, and histopathological features in patients with papillary thyroid carcinoma. Endocr. Pathol. 26(4), 356–364 (2015)
S. Xu, H. Huang, J. Qian et al. Prevalence of Hashimoto thyroiditis in adults with papillary thyroid cancer and its association with cancer recurrence and outcomes. JAMA Netw. Open 4(7), e2118526 (2021)
K.W. Kim, Y.J. Park, E.H. Kim et al. Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto’s thyroiditis. Head. Neck 33(5), 691–695 (2011)
F. Consorti, M. Loponte, F. Milazzo et al. Risk of malignancy from thyroid nodular disease as an element of clinical management of patients with Hashimoto’s thyroiditis. Eur. Surg. Res 45(3-4), 333–337 (2010)
Y.H. Yoon, H.J. Kim, J.W. Lee et al. The clinicopathologic differences in papillary thyroid carcinoma with or without co-existing chronic lymphocytic thyroiditis. Eur. Arch. Otorhinolaryngol. 269(3), 1013–1017 (2012)
K.C. Loh, F.S. Greenspan, F. Dong et al. Influence of lymphocytic thyroiditis on the prognostic outcome of patients with papillary thyroid carcinoma. J. Clin. Endocrinol. Metab. 84(2), 458–463 (1999)
S. Moon, H.S. Chung, J.M. Yu et al. Associations between Hashimoto thyroiditis and clinical outcomes of papillary thyroid cancer: a meta-analysis of observational studies. Endocrinol. Metab. 33(4), 473–484 (2018)
M. Ehlers, M. Schott, Hashimoto’s thyroiditis and papillary thyroid cancer: are they immunologically linked? Trends Endocrinol. Metab. 25(12), 656–664 (2014)
J. Pan, F. Ye, C. Yu et al. Papillary thyroid carcinoma landscape and its immunological link with Hashimoto thyroiditis at single-cell resolution. Front Cell Dev. Biol. 9, 758339 (2021)
M. Ehlers, A. Thiel, C. Bernecker et al. Evidence of a combined cytotoxic thyroglobulin and thyroperoxidase epitope-specific cellular immunity in Hashimoto’s thyroiditis. J. Clin. Endocrinol. Metab. 97(4), 1347–1354 (2012)
A. Willms, D. Bieler, H. Wieler et al. Correlation between sonography and antibody activity in patients with Hashimoto thyroiditis. J. Ultrasound Med 32(11), 1979–1986 (2013)
B.R. Haugen, E.K. Alexander, K.C. Bible 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 26(1), 1–133 (2016)
F. Latrofa, D. Ricci, L. Grasso et al. Characterization of thyroglobulin epitopes in patients with autoimmune and non-autoimmune thyroid diseases using recombinant human monoclonal thyroglobulin autoantibodies. J. Clin. Endocrinol. Metab. 93(2), 591–596 (2008)
D.S. McLeod, D.S. Cooper, P.W. Ladenson et al. Prognosis of differentiated thyroid cancer in relation to serum thyrotropin and thyroglobulin antibody status at time of diagnosis. Thyroid 24(1), 35–42 (2014)
E.S. Kim, D.J. Lim, K.H. Baek et al. Thyroglobulin antibody is associated with increased cancer risk in thyroid nodules. Thyroid 20(8), 885–891 (2010)
E. Fiore, T. Rago, F. Latrofa et al. Hashimoto’s thyroiditis is associated with papillary thyroid carcinoma: role of TSH and of treatment with L-thyroxine. Endocr. Relat. Cancer 18(4), 429–437 (2011)
S. Xu, H. Huang, X. Zhang et al. Predictive value of serum thyroglobulin for structural recurrence following lobectomy for papillary thyroid carcinoma. Thyroid 31(9), 1391–1399 (2021)
Funding
The study was funded by Sanming Project of Medicine in Shenzhen (Grant no. SZSM201911006) and Beijing Hope Run Special Fund of Cancer Foundation of China (Grant no. LC2021A09).
Author information
Authors and Affiliations
Contributions
S.X. participated in the design of the study, data collection and paper writing. H.H. participated in the design of the study and paper writing. J.Q. participated in the data collection and helped to draft the manuscript. X.W. and Z.X. participated in the design of study and manuscript editing. S.L. participated in the data analysis and interpretation and manuscript review. J.L. participated in the design of the study and helped to revise the manuscript. All authors read and approved the final manuscript.
Corresponding authors
Ethics declarations
Conflict of interest
The authors declare no competing interests.
Ethics
The study was approved by the Ethics Committee of the Cancer Hospital, Chinese Academy of Medical Sciences.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Xu, S., Huang, H., Qian, J. et al. Prognostic value of the preoperative and early trends in postoperative serum thyroglobulin antibody levels among patients with papillary thyroid carcinoma and concomitant Hashimoto’s thyroiditis. Endocrine 80, 392–398 (2023). https://doi.org/10.1007/s12020-022-03283-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12020-022-03283-6