[Comparison of administration of rhTSH with withdrawal of thyroid hormone. Follow-up of patients with differentiated thyroid carcinoma].
Recombinant human thyrotropin (rhTSH) has been introduced recently in follow up of differentiated thyroid cancer (DTC) patients, as an alternative of thyroid hormone withdrawal. The aim of this retrospective study is to compare recombinant human thyrotropin versus endogenous stimulation.


METHODS
Thirty-three patients with DTC with previous thyroidectomy and thyroid ablation were selected. All patients underwent whole-body radioiodine scanning and third day serum thyroglobulin (TG) measurement by two techniques, the first one after conventional thyroid hormone withdrawal (TSHe, TGe), and the second one after rhTSH stimulation (TSHr, TGr). Measurement of TG was performed on the third day due to the infrastructure. We only included patients with stable disease, without therapeutic interventions between two consecutive controls in an interval inferior to one year. Two qualitative categories were defined for TG (positive TG > 2 ng/ml or negative TG<2 ng/ml) and whole-body radioiodine scan (positive or negative).


RESULTS
TSHe: 62.9 +/- 55.48; TSHr: 113.16 +/- 50.6; (p: ns); TGe: 62.5 +/- 115.7; TGr: 54.6 +/- 111.1; (p: 0.044). Quantitative data analysis showed significant differences between two techniques. Qualitative data analysis showed no significant differences in clinical setting based in TG and radioiodine scan.


CONCLUSIONS
Administration of rhTSH produces a significantly higher increase of TSH than thyroid hormone withdrawal and lower increase in TG levels. There were no significant differences in the stage of disease (TG and whole-body radioiodine scan).
Caresia
A P
AP
Servicio de Medicina Nuclear, Hospital Universitario Vall d'Hebron, Barcelona, España.
Castell Conesa
J
J
Obiols Alfonso
G
G
Pifarré Montaner
P
P
Negre Busó
M
M
García Alonso
C
C
Galofré Mora
P
P
Mesa Manteca
J
J
D018263:Adenocarcinoma, Follicular / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D002291:Carcinoma, Papillary / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D006801:Humans; D007457:Iodine Radioisotopes; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D013972:Thyrotropin / Q000008:administration & dosage / Q000494:pharmacology*; D013974:Thyroxine / Q000008:administration & dosage* / Q000627:therapeutic use; D014284:Triiodothyronine / Q000008:administration & dosage / Q000627:therapeutic use
D001323:Autoantibodies; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins; C006606:anti-thyroglobulin; D014284:Triiodothyronine; D013972:Thyrotropin; D013954:Thyroglobulin; D013974:Thyroxine