[Will the thyroglobulin assay with lower functional sensitivity whilst the patients are on L-T4 treatment replace the TSH-stimulated thyroglobulin assay in the follow-up of patients with differentiated thyroid cancer?].
The author reviews the literature on the new assays for serum thyroglobulin (sTg) presenting lower functional sensitivity and demonstrates that its use, whilst the patients are taking L-T4, presents better results than sTg following TSH stimulation in the follow-up of patients with differentiated thyroid carcinoma. Therefore, he suggests a revision on the guidelines for the follow-up of these patients (developed when the available assays present a sensitivity of 1 ng/mL), proposing the use of sTg assays with functional sensitivity of 0.1-0.2 ng/mL with the patients on L-T4 treatment instead of sTg stimulated by TSH.
Maciel
Rui M B
RM
Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil. rmbmaciel-endo@pesquisa.epm.br
D000465:Algorithms; D001681:Biological Assay; D002277:Carcinoma / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D018365:Neoplasm, Residual; D017410:Practice Guidelines as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D012015:Reference Standards; D012680:Sensitivity and Specificity; D013268:Stimulation, Chemical; D013954:Thyroglobulin / Q000191:economics / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000191:economics / Q000627:therapeutic use
D011994:Recombinant Proteins; D013972:Thyrotropin; D013954:Thyroglobulin; D013974:Thyroxine