The relationship between thyroglobulin (Tg) levels and distant metastases before radioiodine (RAI) treatment in differentiated thyroid carcinomas

Öz

The aim of our study is to determine the relationship between distant metastases and thyroglobulin (Tg) levels measured before radioiodine (RAI) treatment in differentiated thyroid carcinomas. Sixty seven patients with near total or total thyroidectomy were included in the study. Fifty patients did not have lymph node or distant metastases (Group 1), and 17 patients had distant metastases (Group 2). Tg and anti-Tg levels of these patients were measured before RAI treatment when TSH>30 mU/l. Serum Tg levels were found 8,5±10,6 ng/ml and 307±142 ng/ml in Group 1 and Group 2, respectively. There was a significant difference between the mean Tg levels of Group 1 and 2 (p

Anahtar Kelimeler

• Thyroglobulin,Neoplasm Metastasis,Thyroid Neoplasms

Diferansiye tiroid karsinomlu hastalarda radyoaktif iyot (RAI) tedavi öncesi tiroglobulin (Tg) düzeylerinin uzak metastazlarla ilişkisi

Öz

Çalışmamızın amacı diferansiye tiroid karsinomlarında radyoaktif iyot (RAI) tedavisi öncesi bakılan tiroglobulin (Tg) değerleri ile uzak metastazlar arasındaki ilişkiyi ortaya koymaktır. Çalışmaya total veya totale yakın tiroidektomi geçirmiş 67 diferansiye tiroid karsinomlu hasta dahil edildi. Hastaların 50'sinde lenf nodu ya da uzak metastazı yoktu (Grup 1), 17'sinde ise uzak metastaz mevcuttu (Grup 2). RAI tedavisi öncesinde TSH>30 mU/l iken tüm hastaların anti-Tg ve Tg düzeylerine bakıldı. Serum Tg değerleri Grup 1'de 8,5±10,6 ng/ml, Grup 2'de 307±142 ng/ml olarak bulundu. Grup 1 ve Grup 2'nin Tg ortalamaları arasındaki farkın anlamlı olduğu görüldü (p

Anahtar Kelimeler

• Tiroglobulin,Neoplazm metastazı,Tiroid neoplazmları

Kaynakça

1. . Baloch Z, Carayon P, Conte-Devolx B, Demers LM, FeldtRasmussen U, Henry JF, et al. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid 2003;13(1):3-126.
2. 2. Van Herle AJ, Uller RP, Matthews NI, Brown J. Radioimmunoassay for measurement of thyroglobulin in human serum. J Clin Invest 1973;52(6):1320-7.
3. 3. Coburn M, Teates D, Wanebo HJ. Recurrent thyroid cancer: role of surgery versus radioactive iodine (I-131). Ann Surg 1994;219(6):587-95.
4. 4. Schlumberger M, Challeton C, De Vathaire F, Travagli JP, Gardet P, Lumbroso JD, et al. Radioactive iodine treatment and external radiotherapy for lung and bone metastases from thyroid carcinoma. J Nucl Med 1996;37(4):598-605.
5. 5. Bernier MO, Morel O, Rodien P, Muratet JP, Giraud P, Rohmer V, et al. Prognostic value of an increase in the serum thyroglobulin level at the time of the first ablative radioiodine treatment in patients with differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2005;32(12):1418-21.
6. 6. Lima N, Cavaliere H, Tomimori E, Knobel M, Medeiros-Neto G. Prognostic value of serial serum thyroglobulin determinations after total thyroidectomy for differentiated thyroid cancer. J Endocrinol Invest 2002;25(2):110-5.
7. 7. Ronga G, Filesi M, Ventroni G, Vestri AR, Signore A. Value of the first serum thyroglobulin level after total thyroidectomy for the diagnosis of metastases from differentiated thyroid carcinoma. Eur J Nucl Med 1999;26(11):1448-52.
8. 8. Pezzino V, Vigneri R, Squatrito S, Filetti S, Camus M, Polosa P. Increased serum thyroglobulin levels in patients with nontoxic goiter. J Clin Endocrinol Metab 1978;46(4):653-57.

9. 9. Torrigiani G, Doniach D, Roitt IM. Serum thyroglobulin levels in healthy subjects and in patients with thyroid disease. J Clin Endocrinol Metab 1969;29(3):305-14.
10. 10. Grünwald F, Menzel C, Fimmers R, Zamora PO, Biersack HJ. Prognostic value of thyroglobulin after thyroidectomy before ablative radioiodine therapy in thyroid cancer. J Nucl Med 1996;37(12):1962-4.
11. 11. Girelli ME, Busnardo B, Amerio R, Casara D, Betterle C, Piccolo M. Clinical evaluation of serum thyroglobulin (Tg) levels during thyroid hormone suppression therapy versus Tg levels after hormone withdrawal and total-body scan: results in 291 patients with thyroid cancer. Eur J Nuc Med 1986;11(9):333-5.
12. 12. Kloos RT, 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 2005;90(9):5047-57.
13. 13. Burch HB. Papillary thyroid cancer: follow-up. In: Wartofsky L (ed). Thyroid Cancer: A Comprehensive Guide to Clinical Management. Totowa New Jersey, Humana Press, 2000. 22:229-37.
14. 14. Ma C, Kuang A, Xie J, Ma T. Possible explanations for patients with discordant findings of serum thyroglobulin and 131I whole-body scanning. J Nucl Med 2005;46(9):1473-80.
15. 15. Chung JK, Park YJ, Kim TY, So Y, Kim SK, Park DJ, et al. Clinical significance of elevated level of serum antithyroglobulin antibody in patients with differentiated thyroid cancer after thyroid ablation. Clin Endocrinol (Oxf) 2002;57(2): 215-21.