Combined preoperative thyroglobulin and ACR-TIRADS assessment: implications for fine-needle aspiration biopsy strategy and thyroid cancer diagnosis
Abstract
Purpose: The aim of this study is to evaluate the relationship of Thyroglobulin (Tg) with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) and Bethesda and its correlation with malignancy.
Materials and Methods: The study included 603 cases. Ultrasonography (US), fine needle aspiration biopsy (FNAB), Tg and anti-Tg results were evaluated retrospectively. Nodules were scored according to the ACR-TIRADS. FNAB results were evaluated according to the Bethesda. The relationship between Tg levels, ACR-TIRADS, and FNAB results was evaluated to determine the risk of thyroid malignancy.
Results: The mean age of cases was 50.98±13.73 (min-max: 18-79). 85.1% of the patients were female. Tg was statistically significantly higher in malignant patients (Bethesda 6). In the ROC analysis, the optimum cut-off value for Tg in predicting malignancy was found to be 245 ng/dL. Mean Tg levels were statistically significantly higher in the TIRADS 4, 5 groups than in the TIRADS 2 and 3 groups.
Conclusion: Results showed that Tg is elevated in thyroid nodular disease, especially in malignant nodules. The Tg levels increased in parallel with the ACR-TIRADS malignancy-risk score. If these results are supported by other studies, the evaluation of Tg together with ACR-TIRADS may make an additional contribution to the FNAB decision and the prediction of thyroid malignancies.
Keywords
Kaynakça
- İmga NN, Berger D. Current approach to thyroid cancer. In Diagnostic Approach in Thyroid Nodules: Clinical, Laboratory. (Ed B Çakir):41-2. Ankara, Academician Bookstore. 2020.
- Li S, Ren C, Gong Y, Ye F, Tang Y, Xu J et al. The Role of thyroglobulin in preoperative and postoperative evaluation of patients with differentiated thyroid cancer. Front Endocrinol (Lausanne). 2022;13:872527.
- He LZ, Zeng TS, Pu L, Pan SX, Xia WF, Chen LL. Thyroid hormones, autoantibodies, ultrasonography, and clinical parameters for predicting thyroid cancer. Int J Endocrinol. 2016;8215834.
- Şahin M, Oguz A, Tuzun D, Akkus G, Törün GI, Bahar AY et al. Effectiveness of TI-RADS and ATA classifications for predicting malignancy of thyroid nodules. Adv Clin Exp Med. 2021;30:1133-9.
- Kang YJ, Stybayeya G, Lee JE, Hwang SH. Diagnostic performance of ACR and Kwak TI-RADS for benign and malignant thyroid nodules: An update systematic review and meta-analysis. Cancers (Basel). 2022;2;14:5961.
- Yang R, Zou X, Zeng H, Zhao Y, Ma X. Comparison of diagnostic performance of five different ultrasound TI-RADS classification guidelines for thyroid nodules. Front Oncol. 2020;16:10:598225.
- Algeciras-Schimnich A. Thyroglobulin measurement in the management of patients with differentiated thyroid cancer, Crit Rev Clin Lab Sci. 2018;55:205-18.
- Okamoto T, Kanbe M, Lihara M, Yamazaki K, Okamoto J, Yamashita T et al. Measuring serum thyroglobulin in patients with follicular thyroid nodule: its diagnostic implications. Endocr J. 1997;44:1871-93.
- Cahoon EK, Rozhko A, Hatch M, Polyanskaya O, Ostroumova E, Tang M et al. Factors associated with serum thyroglobulin levels in a population living in Belarus. Clin Endocrinol (Oxf). 2013;79:120-7.
- Kim H, Park SY, Choe JH, Kim JS, Hahn SY, Kim SW et al. Preoperative serum thyroglobulin and its correlation with the burden and extent of differentiated thyroid cancer. Cancers (Basel). 2020;8;12:625.
