Long-term predictive value of highly sensitive thyroglobulin measurement

Larissa R. Bögershausen, Luca Giovanella, Thomas Stief, Markus Luster, Frederik A. Verburg*

*Corresponding author for this work

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Objective: To examine the predictive value of unremarkable nonstimulated highly sensitive thyroglobulin (hsTg) measurement with regard to the results of stimulated thyroglobulin (Tg) measurement, diagnostic whole-body scintigraphy, recurrence and differentiated thyroid cancer (DTC)-related death. Design, Patients and Measurements: We retrospectively analysed the data of all 461 (410 without anti-Tg-antibodies [TgAbs], 51 with) DTC patients who were referred to our department for treatment and follow-up care of differentiated thyroid cancer from 2004 onwards, and in whom at least one posttreatment Tg value was measured in our hospital at least 3 months after I-131 ablation. Results: In the group of TgAb-negative patients, 2.0% of patients with an unstimulated Tg < 0.1 ng/ml showed a stimulated Tg ≥ 1.0 ng/ml, whereas this happened in 77.6% with an unstimulated Tg ≥ 0.1 but <1.0 ng/ml. An unstimulated hsTg ≥ 0.1 ng/ml had a sensitivity specificity positive and negative predictive value of 90.0%, 94.1%, 77.6% and 97.6%, respectively, for a stimulated Tg ≥ 1.0 ng/ml. In TgAb-positive patients, this was 75%, 97%, 75% and 97%, respectively. An unstimulated Tg ≥ 0.1 ng/ml did not significantly discriminate with regard to the risk of DTC-related death (p =.06), but ≥1.0 ng/ml did (p =.012), as did a stimulated Tg ≥ 1.0 ng/ml (p =.029). Excluding patients with distant metastases at diagnosis nullifies this significance. Conclusion: Except for patients with distant metastases, both TgAb negative and TgAb positive patients with an undetectable nonstimulated hsTg measurement have a very good prognosis. The high net present value of unstimulated hsTg testing means that further diagnostic procedures can be omitted in such patients.

Original languageEnglish
JournalClinical Endocrinology
Publication statusE-pub ahead of print - 20 Oct 2022

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© 2022 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd.


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