ABSTRACT
The reliability of thyroglobulin (Tg) measurements in patients with differentiated thyroid cancer (DTC) decreases in anti-thyroglobulin antibody (TgAb) positivity. Although there is no definite judgment about the prognostic significance of TgAb positivity at the time of diagnosis in patients with DTC, if the TgAb value does not decrease or tends to increase during the follow-up, it may be associated with residual or recurrent disease. The management of TgAb elevation is important especially in DTC patients with normal Tg levels after radioactive iodine ablation.
References
1
Robenshtok E, Grewal RK, Fish S, Sabra M, Tuttle RM. A low postoperative nonstimulated serum thyroglobulin level does not exclude the presence of radioactive iodine avid metastatic foci in intermediate-risk differentiated thyroid cancer patients. Thyroid 2013;23:436-442.
2
Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. Lancet 2016;388:2783-2795.
3
Haugen BR, Alexander EK, Bible KC, 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 2016;26:1-133.
4
Spencer C, Petrovic I, Fatemi S. Current thyroglobulin autoantibody (TgAb) assays often fail to detect interfering TgAb that can result in the reporting of falsely low/undetectable serum Tg IMA values for patients with differentiated thyroid cancer. J Clin Endocrinol Metab 2011;96:1283-1291.
5
Spencer C, Fatemi S. Thyroglobulin antibody (TgAb) methods - Strengths, pitfalls and clinical utility for monitoring TgAb-positive patients with differentiated thyroid cancer. Best Pract Res Clin Endocrinol Metab 2013;27:701-712.
6
Taylor KP, Parkington D, Bradbury S, Simpson HL, Jefferies SJ, Halsall DJ. Concordance between thyroglobulin antibody assays. Ann Clin Biochem 2011;48:367-369.
7
La’ulu SL, Slev PR, Roberts WL. Performance characteristics of 5 automated thyroglobulin autoantibody and thyroid peroxidase autoantibody assays. Clin Chim Acta 2007;376:88-95.
8
Zhao L, Liu M, Gao Y, et al. Glycosylation of sera thyroglobulin antibody in patients with thyroid diseases. Eur J Endocrinol 2013;168:585-592.
9
McLachlan SM, Feldt-Rasmussen U, Young ET, et al. IgG subclass distribution of thyroid autoantibodies: a ‘fingerprint’ of an individual’s response to thyroglobulin and thyroid microsomal antigen. Clin Endocrinol (Oxf) 1987;26:335-346.
10
Van Herle AJ, Uller RP, Matthews NI, Brown J. Radioimmunoassay for measurement of thyroglobulin in human serum. J Clin Invest 1973;52:1320-1327.
11
Spencer CA, Bergoglio LM, Kazarosyan M, Fatemi S, LoPresti JS. Clinical impact of thyroglobulin (Tg) and Tg autoantibody method differences on the management of patients with differentiated thyroid carcinomas. J Clin Endocrinol Metab 2005;90:5566-5575.
12
Pickett AJ, Jones M, Evans C. Causes of discordance between thyroglobulin antibody assays. Ann Clin Biochem 2012;49:463-467.
13
Weigle WO, High GJ. The behavior of autologous thyroglobulin in the circulation of rabbits immunized with either heterologous or altered homologous thyroglobulin. J Immunol 1967;98:1105-1114.
14
Hosseini S, Payne RJ, Zawawi F, et al. Can preoperative thyroglobulin antibody levels be used as a marker for well differentiated thyroid cancer? J Otolaryngol Head Neck Surg 2016;45:31.
15
Pedersen IB, Knudsen N, Carlé A, et al. A cautious iodization programme bringing iodine intake to a low recommended level is associated with an increase in the prevalence of thyroid autoantibodies in the population. Clin Endocrinol (Oxf) 2011;75:120-126.
16
Lee JH, Kim Y, Choi JW, Kim YS. The association between papillary thyroid carcinoma and histologically proven Hashimoto’s thyroiditis: a meta-analysis. Eur J Endocrinol 2013;168:343-349.
17
Jankovic B, Le KT, Hershman JM. Clinical Review: Hashimoto’s thyroiditis and papillary thyroid carcinoma: is there a correlation? J Clin Endocrinol Metab 2013;98:474-482.
18
Lun Y, Wu X, Xia Q, et al. Hashimoto’s thyroiditis as a risk factor of papillary thyroid cancer may improve cancer prognosis. Otolaryngol Head Neck Surg 2013;148:396-402.
19
Kim EY, Kim WG, Kim WB, et al. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma. Clin Endocrinol (Oxf) 2009;71:581-586.
20
Latrofa F, Ricci D, Montanelli L, et al. Lymphocytic thyroiditis on histology correlates with serum thyroglobulin autoantibodies in patients with papillary thyroid carcinoma: impact on detection of serum thyroglobulin. J Clin Endocrinol Metab 2012;97:2380-2387.
21
Okosieme OE, Evans C, Moss L, Parkes AB, Premawardhana LD, Lazarus JH. Thyroglobulin antibodies in serum of patients with differentiated thyroid cancer: relationship between epitope specificities and thyroglobulin recovery. Clin Chem 2005;51:729-734.
22
Görges R, Maniecki M, Jentzen W, et al. Development and clinical impact of thyroglobulin antibodies in patients with differentiated thyroid carcinoma during the first 3 years after thyroidectomy. Eur J Endocrinol 2005;153:49-55.
23
Kim WG, Yoon JH, Kim WB, et al. Change of serum antithyroglobulin antibody levels is useful for prediction of clinical recurrence in thyroglobulin-negative patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab 2008;93:4683-4689.
24
Chiovato L, Latrofa F, Braverman LE, et al. Disappearance of humoral thyroid autoimmunity after complete removal of thyroid antigens. Ann Intern Med 2003;139:346-351.
25
Ozkan E, Soydal C, Araz M, Aras G, Ibis E. The additive clinical value of 18F-FDG PET/CT in defining the recurrence of disease in patients with differentiated thyroid cancer who have isolated increased antithyroglobulin antibody levels. Clin Nucl Med 2012;37:755-758.
26
Slifka MK, Antia R, Whitmire JK, Ahmed R. Humoral immunity due to long-lived plasma cells. Immunity 1998;8:363-372.
27
Polyzos SA, Anastasilakis AD. Alterations in serum thyroid-related constituents after thyroid fine-needle biopsy: a systematic review. Thyroid 2010;20:265-271.
28
Ernaga-Lorea A, Hernández-Morhain MC, Anda-Apiñániz E, et al. Prognostic value of change in anti-thyroglobulin antibodies after thyroidectomy in patients with papillary thyroid carcinoma. Clin Transl Oncol 2018;20:740-744.
29
Trimboli P, Zilioli V, Imperiali M, Giovanella L. Thyroglobulin autoantibodies before radioiodine ablation predict differentiated thyroid cancer outcome. Clin Chem Lab Med 2017;55:1995-2001.
30
American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-1214.
31
Ringel MD, Nabhan F. Approach to follow-up of the patient with differentiated thyroid cancer and positive anti-thyroglobulin antibodies. J Clin Endocrinol Metab 2013;98:3104-3110.
32
Hung GU, Lee KW, Liao PY, Yang LH, Yang KT. The influence of I-131 therapy on FDG uptake in differentiated thyroid cancer. Ann Nucl Med 2008;22:481-485.
33
Alnafisi NS, Driedger AA, Coates G, Moote DJ, Raphael SJ. FDG PET of recurrent or metastatic 131I-negative papillary thyroid carcinoma. J Nucl Med 2000;41:1010-1015.