Thyroglobulin antibodies as a potential predictive marker of papillary thyroid carcinoma in patients with indeterminate cytology.
BACKGROUND
We investigated the efficacy of thyroglobulin antibodies (TgAb) in detecting malignancy in indeterminate thyroid nodules and evaluated the possible association between TgAb and autoimmunity in papillary thyroid carcinoma (PTC).


METHODS
This retrospective, nonrandomized study included 1,646 patients who had undergone preoperative fine-needle aspiration biopsy to evaluate their thyroid nodules, and then standard total thyroidectomy. Of 194 patients (11.8%) with indeterminate nodules, 61 (31.4%) had PTC and 133 (68.6%) had benign nodules at the final histologic examination.


RESULTS
Univariate analysis showed that multifocality (P = .002), bilaterality (P = .003), lymph-node metastasis (P = .030), and capsule penetration (P = .003) were significantly associated with positive TgAb in patients with indeterminate cytology and histopathologic diagnosis of PTC. The multivariate analysis showed that TgAb positivity (P < .001) and preoperative thyroid-stimulating hormone levels (P = .022) were independent predictive factor for PTC diagnosis in patients with indeterminate cytology.


CONCLUSIONS
Preoperative TgAb could be a marker for PTC in patients with indeterminate thyroid nodules, increasing diagnostic accuracy. TgAb positivity could also influence the clinical assessment and subsequent selection of total thyroidectomy.
Second Department of Propedeutic Surgery, Medical School, University of Athens, Laikon General Hospital, Athens, Greece.
Theodore
T
Karatzas
Department of Otolaryngology/Head and Neck Surgery, Venizeleio - Pananeio General Hospital, Herakleion, Greece; Department of Otolaryngology - Head and Neck Surgery, Royal London Hospital, Barts and the London Trust, London, UK. Electronic address: j.vasileiadis@yahoo.gr.
Ioannis
I
Vasileiadis
Endocrine Unit, First Department of Internal Medicine, Medical School, University of Athens, Laikon General Hospital, Athens, Greece.
Evangelia
E
Zapanti
Department of Otolaryngology/Head and Neck Surgery, Venizeleio - Pananeio General Hospital, Herakleion, Greece.
Georgios
G
Charitoudis
Department of Otolaryngology/Head and Neck Surgery, Venizeleio - Pananeio General Hospital, Herakleion, Greece.
Efthimios
E
Karakostas
Endocrine Unit, Department of Pathophysiology, Medical School, University of Athens, Laikon General Hospital, Athens, Greece.
Georgios
G
Boutzios
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000097:blood / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015996:Survival Rate; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016606:Thyroid Nodule / Q000097:blood / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome
D001323:Autoantibodies; D014408:Biomarkers, Tumor; C006606:anti-thyroglobulin
Indeterminate cytology; Papillary thyroid carcinoma; Predictive marker; Thyroglobulin antibody; Thyroid nodules; Thyroidectomy