Sommario
Nei pazienti affetti da carcinoma differenziato della tiroide, la rilevanza clinica ed economica di un follow-up ottimale, attraverso test diagnostici accurati, è una questione fondamentale, considerando il grande numero di pazienti nel mondo che vi si sottopongono per tutta la vita. In questo contesto, la recente introduzione nella pratica clinica di metodiche ultrasensibili per il dosaggio della tireoglobulina (Tg, sensibilità funzionale di 0,1 ng/ml) ha sensibilmente migliorato l’impiego clinico della Tg in terapia con ormoni tiroidei nel follow-up dei pazienti con carcinoma differenziato della tiroide.
Bibliografia
Cooper DS, Doherty GM, Haugen BR et al. (2006) Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 16:109–142
Smallridge RC, Meek SE, Morgan MA et al. (2007) Monitoring thyroglobulin in a sensitive immunoassay has comparable sensitivity to recombinant human tsh-stimulated thyroglobulin in follow-up of thyroid cancer patients. J Clin Endocrinol Metab 92:82–87
Iervasi A, Iervasi G, Ferdeghini M et al. (2007) Clinical relevance of highly sensitive Tg assay in monitoring patients treated for differentiated thyroid cancer. Clin Endocrinol 67:434–441
Rosario PW, Purisch S (2008) Does a highly sensitive thyroglobulin (Tg) assay change the clinical management of low-risk patients with thyroid cancer with Tg on T4<1 ng/ml determined by traditional assays? Clin Endocrinol 68:338–342
Spencer C, Fatemi S, Singer P et al. (2010) Serum basal thyroglobulin measured by a second-generation assay correlates with the recombinant human thyrotropin-stimulated thyroglobulin response in patients treated for differentiated thyroid cancer. Thyroid 20:587–595
Schlumberger M, Hitzel A, Toubert ME et al. (2007) Comparison of seven serum thyroglobulin assays in the follow-up of papillary and follicular thyroid cancer patients. J Clin Endocrinol Metab 92:2487–2495
Castagna MG, Tala Jury HP, Cipri C et al. (2011) The use of ultrasensitive thyroglobulin assays reduces but does not abolish the need for TSH stimulation in patients with differentiated thyroid carcinoma. J Endocrinol Invest 34:219–223
Malandrino P, Latina A, Marescalco S et al. (2011) Risk-adapted management of differentiated thyroid cancer assessed by a sensitive measurement of basal serum thyroglobulin. J Clin Endocrinol Metab 96:1703–1709
Brassard M, Borget I, Edet-Sanson A et al. (2011) Long-term follow-up of patients with papillary and follicular thyroid cancer: a prospective study on 715 patients. J Clin Endocrinol Metab 96:1352–1359
Chindris AM, Diehl NN, Crook JE et al. (2012) Undetectable sensitive serum thyroglobulin (<0.1 ng/ml) in 163 patients with follicular cell-derived thyroid cancer: results of rhTSH stimulation and neck ultrasonography and long-term biochemical and clinical follow-up. J Clin Endocrinol Metab 97:2714–2723
Rosario PW, dos Santos JB, Calsolari MR (2013) Follow-up of patients with low-risk papillary thyroid carcinoma and undetectable basal serum thyroglobulin after ablation measured with a sensitive assay: a prospective study. Horm Metab Res 45:911–914
Zöphel K, Wunderlich G, Smith BR (2003) Serum thyroglobulin measurements with a high sensitivity enzyme-linked immunosorbent assay: is there a clinical benefit in patients with differentiated thyroid carcinoma? Thyroid 13:861–865
Conflitto di interesse
L’autrice Maria Grazia Castagna dichiara di non avere conflitti di interesse.
Consenso informato
Lo studio presentato in questo articolo non ha richiesto sperimentazione umana.
Studi sugli animali
L’autrice di questo articolo non ha eseguito studi sugli animali.
Author information
Authors and Affiliations
Corresponding author
Additional information
Proposta da Michele Marinò.
Materiale elettronico supplementare
Rights and permissions
About this article
Cite this article
Castagna, M.G. Significato clinico del dosaggio della tireoglobulina ultrasensibile nel carcinoma tiroideo differenziato. L'Endocrinologo 15, 60–64 (2014). https://doi.org/10.1007/s40619-014-0018-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40619-014-0018-9