Dynamics of serum antithyroglobulin antibodies in patients with differentiated thyroid cancer
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ORIGINAL ARTICLE
Dynamics of serum antithyroglobulin antibodies in patients with differentiated thyroid cancer Fernanda Bueno1 María Gabriela García Falcone1 Mirna Angela Peñaloza1 Erika Abelleira1 Fabián Pitoia ●
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Received: 6 July 2019 / Accepted: 2 October 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Purpose Serum antithyroglobulin antibodies (sTgAb) affect the reliability of Tg measurement in patients with thyroid cancer. We compared the outcome of patients with detectable and undetectable sTgAb, stratified according to the initial risk of recurrence (RR); also the response to treatment in patients with detectable sTgAb treated with total thyroidectomy (TT) with and without radioiodine remnant ablation (RA) and the sTgAb trend in the long-term follow-up according to the initial response. Methods We included 432 patients submitted to TT, with or without RA; 106 patients had detectable sTgAb levels. Median follow-up was 53 months. Results There were no statistically significant differences considering presentation between negative or positive sTgAb subjects. The frequency of structural incomplete response (SIR) in low, intermediate, and high RR was similar. Undetectable sTgAb in patients was achieved in a median of 16 months in ablated patients compared with 11 months in those without RA (p = 0.0232). Patients without RA had a higher rate of undetectable sTgAb during the first 12 months. A SIR was observed in 3% of patients with declining sTgAb, in 19% of those with stable levels, and in 43% with increasing sTgAb (p = 0.004). The status of no evidence of disease was achieved more frequently in patients with initial sTgAb levels < 200 mUI/l, independently of the initial RR. Conclusions There was no impact of sTgAb on the initial clinical presentation and the response to therapy in low-risk patients treated with or without RA. sTgAb trend is more useful than an absolute value to predict a SIR. Keywords Thyroid cancer Antithyroglobulin antibodies Risk of recurrence Response to therapy Ablation ●
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Introduction Differentiated thyroid carcinoma (DTC) has an excellent prognosis with 10-year survival rates of 85–93% [1]. Total thyroidectomy (TT) followed by radioiodine remnant ablation (RA) is the usual treatment for DTC; nowadays the therapy is selected according to the risk of recurrence (RR) [2–4]. After this initial approach, serum thyroglobulin (Tg) level is an important marker for identifying those cases with persistent or recurrent disease [5–7]. However, the reliability of serum Tg measurement is significantly impaired by coexistent serum antithyroglobulin antibodies (sTgAb)
* Fabián Pitoia [email protected] 1
Division of Endocrinology, Hospital de Clínicas-University of Buenos Aires, Buenos Aires, Argentina
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[8–11]. This concept is so well established that the last American Thyroid Association guidelines for the management of DTC include the Tg and TgAb measurement after initial treatment as an essential tool to assess
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