title: Prognostic significance of changes in serum thyroglobulin antibody levels of pre- and post-total thyroidectomy in thyroglobulin antibody-positive papillary thyroid carcinoma patients.
abstract: Although postoperative serum thyroglobulin (Tg) is a prognostic indicator for papillary thyroid carcinoma (PTC), it is unreliable when Tg antibody (TgAb) is positive. We evaluated the prognostic significance of changes in serum TgAb levels of pre- and post-total thyroidectomy in TgAb-positive PTC patients. We reviewed our medical charts of 225 TgAb-positive PTC patients in whom TgAb levels were measured before and 1-2 years after total thyroidectomy, performed between April 2002 and March 2007. We divided them into 3 groups based on changes in TgAb levels. Postoperative serum TgAb levels decreased by ≥ 50% in 181 patients (80.4%) (Group 1), by <50% in 22 patients (9.8%) (Group 2), and increased in 22 patients (9.8%) (Group 3). During the follow-up, 3 patients died of the disease and 14 patients had recurrences. All 3 patients who died of PTC were seen only in Groups 2 and 3. Groups 2 and 3 showed similar prognostic outcomes, thus were analyzed together as Group 2+3. Group 1 had significantly better lymph node recurrence-free survival and distant recurrence-free survival than Group 2+3 (96.9% vs. 90.5%, p <0.001, and 98.9% vs. 90.1%, p = 0.004, respectively at 5 years). Multivariate analyses on prognostic factors revealed that classification to Group 2+3 was the strongest indicator for poor prognosis. The present results suggest that changes in TgAb levels following total thyroidectomy can be an important dynamic prognostic factor of PTC patients. Prospective periodical measurements of TgAb are necessary to confirm these findings.
authors.affiliation: Department of Breast and Endocrine Surgery, Nagoya University, Nagoya 466-8550, Japan. yukkotsushima@med.nagoya-u.ac.jp
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tsushima
authors.forename: Akira
authors.initials: A
authors.lastname: Miyauchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Takumi
authors.initials: T
authors.lastname: Kudo
authors.forename: Hiroo
authors.initials: H
authors.lastname: Masuoka
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yabuta
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fukushima
authors.forename: Minoru
authors.initials: M
authors.lastname: Kihara
authors.forename: Takuya
authors.initials: T
authors.lastname: Higashiyama
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Takamura
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Miya
authors.forename: Toyone
authors.initials: T
authors.lastname: Kikumori
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Imai
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kiuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D002277:Carcinoma / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D002291:Carcinoma, Papillary; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001323:Autoantibodies; C006606:anti-thyroglobulin