Ability of the rhTSH stimulation test to predict relapse in patients with differentiated thyroid carcinoma, after long-term follow-up

Marcelino,Mafalda; Lopes,Ana   Filipa; Madureira,Deolinda; Ferreira,Teresa   C.; Limbert,Edward; Leite,Valeriano

doi:10.3892/ol.2015.2854

March-2015 Volume 9 Issue 3

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

March-2015 Volume 9 Issue 3

Full Size Image

Article

Ability of the rhTSH stimulation test to predict relapse in patients with differentiated thyroid carcinoma, after long-term follow-up

Authors:
- Mafalda Marcelino
- Ana Filipa Lopes
- Deolinda Madureira
- Teresa C. Ferreira
- Edward Limbert
- Valeriano Leite
View Affiliations / Copyright

Affiliations: Department of Endocrinology, Portugese Institute of Oncology, Lisbon 1600‑608, Portugal, Laboratory of Endocrinology, Portugese Institute of Oncology, Lisbon 1600‑608, Portugal, Department of Nuclear-Medicine, Portugese Institute of Oncology, Lisbon 1600‑608, Portugal
Pages: 1281-1286
|
Published online on: January 7, 2015

https://doi.org/10.3892/ol.2015.2854
Expand metrics +

Abstract

The analysis of serum thyroglobulin (Tg) following thyroid‑stimulating hormone (TSH) stimulation (sTg) has been recommended in the follow‑up of differentiated thyroid carcinoma (DTC) patients, however, its routine use remains controversial. The aim of the current study was to evaluate the accuracy of sTg testing following recombinant human (rh) TSH stimulation in DTC patients, with a follow‑up of 12.4 years. Retrospective studies were conducted of 125 DTC patients, who underwent rhTSH stimulation testing between 1999 and 2002. The exclusion criteria were: Patients with anti‑Tg antibodies, Tg levels >1 ng/ml under TSH suppression and the absence of radioactive iodine (RAI) ablation therapy following surgery. In total, 49 patients were included in the study and all had been previously treated with total or near total thyroidectomy (with or without central neck dissection) and RAI, postoperatively. The Tg functional sensitivity was 1.0 ng/ml. The follow‑up for patients was performed annually. During the median follow‑up of 12.4 years after the rhTSH stimulation test, nine patients exhibited recurrence (18.4%). Of the nine patients, six exhibited sTg levels >2 ng/ml (positive result) and three exhibited levels <2 ng/ml (negative result). Relapse occurred at a mean of 5.9 years following the rhTSH stimulation test. The positive predictive value and negative predictive value (NPV) of positive sTg were 50 and 91.9%, respectively, with a sensitivity of 66.6% and a specificity of 85.0%. The rhTSH‑stimulated Tg levels have a high NPV, allowing the identification of the patients who are free of the tumour. These results are consistent with the previously published data; however, to the best of our knowledge, this is the study with the longest follow‑up duration after rhTSH stimulation.

View Figures

View References

1	Jemal A, Siegel R, Ward E, et al: Cancer statistics, 2006. CA Cancer J Clin. 56:106–130. 2006. View Article : Google Scholar : PubMed/NCBI
2	Davies L and Welch HG: Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA. 295:2164–2167. 2006. View Article : Google Scholar : PubMed/NCBI
3	Hundahl SA, Fleming ID, Fremgen AM and Menck HR: A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995 [see commetns]. Cancer. 83:2638–2648. 1998. View Article : Google Scholar
4	Brassard M, Borget I, Edet-Sanson A, et al: 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. 2011. View Article : Google Scholar : PubMed/NCBI
5	Mazzaferri EL: An overview of the management of papillary and follicular thyroid carcinoma. Thyroid. 9:421–427. 1999. View Article : Google Scholar : PubMed/NCBI
6	Mazzaferri EL and Kloos RT: Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab. 86:1447–1463. 2001. View Article : Google Scholar : PubMed/NCBI
7	American Thyroid Association (ATA) Guidelines Taskforce on Thyroid N, 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. 19:1167–1214. 2009. View Article : Google Scholar : PubMed/NCBI
8	Schlumberger M, Borget I, Nascimento C, Brassard M and Leboulleux S: Treatment and follow-up of low-risk patients with thyroid cancer. Nat Rev Endocrinol. 7:625–628. 2011. View Article : Google Scholar : PubMed/NCBI
9	Castagna MG, Brilli L, Pilli T, et al: Limited value of repeat recombinant human thyrotropin (rhTSH)-stimulated thyroglobulin testing in differentiated thyroid carcinoma patients with previous negative rhTSH-stimulated thyroglobulin and undetectable basal serum thyroglobulin levels. J Clin Endocrinol Metab. 93:76–81. 2008. View Article : Google Scholar
10	Kloos RT and Mazzaferri EL: A single recombinant human thyrotropin-stimulated serum thyroglobulin measurement predicts differentiated thyroid carcinoma metastases three to five years later. J Clin Endocrinol Metab. 90:5047–5057. 2005. View Article : Google Scholar : PubMed/NCBI
11	Melo M, Costa G, Ribeiro C, et al: Stimulated thyroglobulin at recombinant human TSH-aided ablation predicts disease-free status one year later. J Clin Endocrinol Metab. 98:4364–4372. 2013. View Article : Google Scholar : PubMed/NCBI
12	Wittekind C, Compton CC, Greene FL and Sobin LH: TNM residual tumor classification revisited. Cancer. 94:2511–2516. 2002. View Article : Google Scholar : PubMed/NCBI
13	Kloos RT: Thyroid cancer recurrence in patients clinically free of disease with undetectable or very low serum thyroglobulin values. J Clin Endocrinol Metab. 95:5241–5248. 2010. View Article : Google Scholar : PubMed/NCBI
14	Robbins RJ, Chon JT, Fleisher M, Larson SM and Tuttle RM: Is the serum thyroglobulin response to recombinant human thyrotropin sufficient, by itself, to monitor for residual thyroid carcinoma? J Clin Endocrinol Metab. 87:3242–3247. 2002. View Article : Google Scholar : PubMed/NCBI
15	Mazzaferri EL and Kloos RT: Is diagnostic iodine-131 scanning with recombinant human TSH useful in the follow-up of differentiated thyroid cancer after thyroid ablation? J Clin Endocrinol Metab. 87:1490–1498. 2002. View Article : Google Scholar : PubMed/NCBI
16	Giovanella L, Ceriani L, Ghelfo A, et al: Thyroglobulin assay during thyroxine treatment in low-risk differentiated thyroid cancer management: comparison with recombinant human thyrotropin-stimulated assay and imaging procedures. Clin Chem Lab Med. 44:648–652. 2006. View Article : Google Scholar : PubMed/NCBI
17	Smallridge RC, Meek SE, Morgan MA, et al: 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. 2007. View Article : Google Scholar
18	Schlumberger M, Hitzel A, Toubert ME, et al: Comparison of seven serum thyroglobulin assays in the follow-up of papillary and follicular thyroid cancer patients. J Clin Endocrinol Metab. 92:2487–2495. 2007. View Article : Google Scholar : PubMed/NCBI
19	Nascimento C, Borget I, Al Ghuzlan A, et al: Persistent disease and recurrence in differentiated thyroid cancer patients with undetectable postoperative stimulated thyroglobulin level. Endocr Relat Cancer. 18:R29–R40. 2011.
20	Pacini F, Molinaro E, Castagna MG, et al: Recombinant human thyrotropin-stimulated serum thyroglobulin combined with neck ultrasonography has the highest sensitivity in monitoring differentiated thyroid carcinoma. J Clin Endocrinol Metab. 88:3668–3673. 2003. View Article : Google Scholar : PubMed/NCBI
21	Torlontano M, Crocetti U, Augello G, et al: Comparative evaluation of recombinant human thyrotropin-stimulated thyroglobulin levels, 131I whole-body scintigraphy, and neck ultrasonography in the follow-up of patients with papillary thyroid microcarcinoma who have not undergone radioiodine therapy. J Clin Endocrinol Metab. 91:60–63. 2006. View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Ability of the rhTSH stimulation test to predict relapse in patients with differentiated thyroid carcinoma, after long-term follow-up

This article is mentioned in:

Abstract

Figure 1

Related Articles