Thyroglobulin Antibodies Could be a Potential Predictive Marker for Papillary Thyroid Carcinoma
- 687 Downloads
Hashimoto thyroiditis (HT) is associated with an increased risk of developing papillary thyroid carcinoma (PTC). The relationship between thyroid autoimmunity and cancer remains controversial. The purpose of this study was to investigate whether the preoperative TgAb could be a potential predictor of PTC in patients with thyroid nodules and to assess whether there is an association of preoperative TgAb with lymph node metastases.
This retrospective, nonrandomised study included 854 patients who underwent standard total thyroidectomy. Benign thyroid nodules were diagnosed in 447 patients, and 407 presented with malignant nodules. The examined parameters included the clinical characteristics, preoperative TSH and TgAb levels, and the histopathological characteristics of the tumour.
Tumour size >10 mm (p = 0.01), the presence of PTC (p < 0.001), elevated TSH levels (2.64 ± 1.28 μU/ml vs. 2.09 ± 0.98 μU/ml, p = 0.001), HT (p < 0.001), and lymph node metastasis (p = 0.005) were significantly associated with positive TgAb. Additionally, tumour size >10 mm (p < 0.001), preoperative TgAb positivity (p = 0.003), and elevated TSH levels (TSH > 3.4 μU/ml, p = 0.038) were independent risk factors for PTC based on the multivariate logistic regression analysis.
This study showed that TgAb positivity was an independent risk factor for PTC. A positive correlation between TgAb and PTC in patients with indeterminate nodules was existed. Additionally, a positive correlation existed between TgAb and lymph node metastases in patients with PTC. Prospective studies with a larger number of patients and long-term follow-up are needed clarify the potential role of positive serum TgAb in the prediction of PTC.
KeywordsThyroid Carcinoma Papillary Thyroid Carcinoma Thyroid Nodule Autoimmune Thyroiditis Benign Nodule
Conflict of interest
There are no potential conflicts of interest, financial or otherwise, for the participating authors.
- 6.Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES, Orcutt J, Moore FD Jr, Larsen PR, Marqusee E, Alexander EK. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab. 2006;91:3411–7.PubMedCrossRefGoogle Scholar
- 7.Spencer CA, Takeuchi M, Kazarosyan M, Wang CC, Guttler RB, Singer PA, Fatemi S, LoPresti JS, Nicoloff JT. Serum thyroglobulin autoantibodies: prevalence, influence on serum thyroglobulin measurement and prognostic significance in patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab. 1998;83:1121–7.PubMedGoogle Scholar
- 11.Latrofa F, Ricci D, Grasso L, Vitti P, Masserini L, Basolo F, Ugolini C, Mascia G, Lucacchini A, Pinchera A. Characterization of thyroglobulin epitopes in patients with autoimmune and non-autoimmune thyroid diseases using recombinant human monoclonal thyroglobulin autoantibodies. J Clin Endocrinol Metab. 2008;93:591–6.PubMedCrossRefGoogle Scholar
- 14.Rago T, Di Coscio G, Ugolini C, Scutari M, Basolo F, Latrofa F, Romani R, Berti P, Grasso L, Braverman LE, Pinchera A, Vitti P. Clinical features of thyroid autoimmunity are associated with thyroiditis on histology and are not predictive of malignancy in 570 patients with indeterminate nodules on cytology who had a thyroidectomy. Clin Endocrinol. 2007;67:363–9.CrossRefGoogle Scholar
- 19.Boutzios G, Vasileiadis I, Zapanti E, Charitoudis G, Karakostas E, Ieromonachou P, Karatzas T. Higher incidence of Tall cell variant of papillary thyroid carcinoma in Graves’ disease. Thyroid. 2014;24:347–54.Google Scholar
- 24.Haymart MR, Repplinger DJ, Leverson GE, Elson DF, Sippel RS, Jaume JC, Chen H. Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocrinol Metabol. 2008;93:809–14.CrossRefGoogle Scholar
- 27.American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and differentiated thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, et al. Revised American. Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167–214.Google Scholar
- 29.McLeod DS, Cooper DS, Ladenson PW, Ain KB, Brierley J, Fein HG, Haugen BR, Jonklaas J, Magner J, Ross DD, Skarulis MC, Steward D, Maxon H, Sherman SI. Prognosis of differentiated thyroid cancer in relation to serum TSH and thyroglobulin antibody status at the time of diagnosis. Thyroid. 2014;24:35–42.Google Scholar
- 30.Fiore E, Rago T, Latrofa F, Provenzale MA, Piaggi P, Delitala A, Scutari M, Basolo F, Di Corsio G, Grasso L, Pinchera A, Vitti P. Hashimoto’s thyroiditis is associated with papillary thyroid carcinoma: role of TSH and of treatment with L-thyroxine. Endocr Relat Cancer. 2011;18:429–37.PubMedCrossRefGoogle Scholar
- 31.Fiore E, Rago T, Provenzale MA, Scutari M, Ugolini C, Basolo F, Di Corsio G, Berti P, Grasso L, Elisei R, Pinchera A, Vitti P. Lower levels of TSH are associated with a lower risk of papillary thyroid cancer in patients with thyroid nodular disease: thyroid autonomy may play a protective role. Endocr Relat Cancer. 2009;16:1251–60.PubMedCrossRefGoogle Scholar
- 34.Giagourta I, Evangelopoulou C, Papaioannou G, Kassi G, Zapanti E, Prokopiou M, Papapostolou K, Karga H. Autoimmune thyroiditis in benign and malignant thyroid nodules: 16-year results. Head Neck. 2013. doi: 10.1002/hed.23331.