Journal articles: 'Thyroid cancer, Thyroglobulin'

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Silgado, Maria Laura Ricardo, Arnav Kamat, Nazia Sadiq, Gul Bahtiyar, and Giovanna Rodriguez. "ODP489 Insular Thyroid Cancer: A Rare Case of Undifferentiated Thyroid Carcinoma." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A769—A770. http://dx.doi.org/10.1210/jendso/bvac150.1589.

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Abstract Introduction Insular thyroid cancer (ITC) is a rare form of thyroid cancer derived from follicular cells. ITC requires a histopathologic diagnosis and has an intermediate morphology between well differentiated thyroid cancers (follicular and papillary) and undifferentiated thyroid cancer (anaplastic). The rate of metastasis and mortality are higher compared with well-differentiated thyroid carcinomas. Case presentation A 74-year-old woman presented for a 1 year history of rapidly progressive neck mass associated with neck pain, limited neck motion, loss of appetite, weight loss, and dysphagia. Past medical history included hypertension, type 2 diabetes, dyslipidemia, and vitamin D deficiency. There was no history of neck radiation or family history of cancer. Physical examination revealed a 10×7 cm neck mass with cervical adenopathy. Vital signs were unremarkable. Laboratory studies showed TSH of 0.71 uIU/mL (0.270-4.200), free T4 of 0.57 ng/dL (0.93-1.70) and thyroglobulins of 213.616 ng/dL (1.6-59.9). Neck CT demonstrated a multilobulated mass in the left thyroid lobe measuring 12×5.2×5.6 cm with tracheal deviation, multiple nodules surrounding the carotids and bone metastasis. Fine needle aspiration showed a mixed pattern of thyroid follicles. An excisional biopsy showed nests and sheets of small uniform cells with scattered abortive follicles and mitosis consistent with ITC. There was no necrosis. The Ki67 index was 10-20%. On immunohistochemical analysis TTF1 and thyroglobulin were positive and P63, calcitonin, and PTH were negative. Tracheostomy and PEG tube placement were required due to mass obstructive effect. Radiation and steroids were initiated before starting lenvatinib. The patient was not a surgical candidate due to tumor extension to the carotids. She ultimately succumbed to the disease after a 45-day hospital course complicated by pneumonia. Discussion ITC is a rare type of thyroid tumor with a mortality rate of 12-75%. The diagnosis is based on histopathology, demonstrating solid nests (insulae) of small, uniform carcinoma cells, small follicles containing thyroglobulin, frequent necrotic foci and variable mitotic activity. The tumor cells in ITC are derived from poorly differentiated follicular cells expressing thyroglobulin. The immunostaining of thyroglobulin differentiates ITC from other poorly differentiated thyroid tumors. In this case the immunohistochemical analysis was positive for thyroglobulin and negative for calcitonin, which confirmed that the tumor cells were follicular in origin 1 . ITC behaves differently compared with other thyroid carcinomas, with more frequent metastasis and lower average 20-year post-diagnosis survival. Our patient had other characteristics that conferred a poor prognosis, including advanced age, high rate of mitosis, and multiple metastases. Although surgery and radioactive iodine are first line, this patient's tumor extension required alternative therapies. Radiotherapy and lenvatinib, a tyrosine kinase receptor inhibitor, were employed unsuccessfully. 1. Soza, J., et al. Insular Thyroid Cancer. Cancer, 3260-3267. Presentation: No date and time listed

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Evans, Carol, Sarah Tennant, and Petros Perros. "Thyroglobulin in differentiated thyroid cancer." Clinica Chimica Acta 444 (April 2015): 310–17. http://dx.doi.org/10.1016/j.cca.2014.10.035.

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Lin, Jen-Der. "Thyroglobulin and human thyroid cancer." Clinica Chimica Acta 388, no. 1-2 (February 2008): 15–21. http://dx.doi.org/10.1016/j.cca.2007.11.002.

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Xiao, Qian, Qiang Jia, Jian Tan, and Zhaowei Meng. "Serum biomarkers for thyroid cancer." Biomarkers in Medicine 14, no. 9 (June 2020): 807–15. http://dx.doi.org/10.2217/bmm-2019-0578.

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The high prevalence of thyroid cancer requires a reliable serum biomarker for diagnosis and prognostic monitoring. Serum thyroglobulin has been established as the primary postoperative and postablative monitoring biomarker for this malignancy. However, the presence of thyroglobulin antibody imposes a significant interference on its overall management, which cannot be diminished by currently available assays. Trends on the level of the thyroglobulin antibody during follow-up is considered as a surrogate biomarker, but controversy exists. A variety of alternative biomarkers are being proposed and investigated, nevertheless, clinical trials and prospective validations are needed before they can be regarded as clinically viable serum parameters for thyroid cancer.

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Shulan, Joseph M., Leonid Vydro, Arthur B. Schneider, and Dan V. Mihailescu. "Role of biomarkers in predicting the occurrence of thyroid neoplasms in radiation-exposed children." Endocrine-Related Cancer 25, no. 4 (April 2018): 481–91. http://dx.doi.org/10.1530/erc-17-0408.

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With increasing numbers of childhood cancer survivors who were treated with radiation, there is a need to evaluate potential biomarkers that could signal an increased risk of developing thyroid cancer. We aimed to examine the relationships between thyrotropin and thyroglobulin levels and the risk of developing thyroid nodules and cancer in a cohort of radiation-exposed children. 764 subjects who were irradiated in the neck area as children were examined and followed for up to 25 years. All subjects underwent a clinical examination, measurements of thyrotropin, thyroglobulin levels and thyroid imaging. At baseline, 216 subjects had thyroid nodules and 548 did not. Of those with nodules, 176 underwent surgery with 55 confirmed thyroid cancers. During the follow-up, 147 subjects developed thyroid nodules including 22 with thyroid cancer. Thyroglobulin levels were higher in subjects with prevalent thyroid nodules (26.1 ng/mL vs 9.37 ng/mL; P < 0.001) and in those who had an initial normal examination but later developed thyroid nodules (11.2 ng/mL vs 8.87 ng/mL; P = 0.017). There was no relationship between baseline thyrotropin levels and the prevalent presence or absence of thyroid nodules, whether a prevalent neoplasm was benign or malignant, subsequent development of thyroid nodules during follow-up or whether an incident nodule was benign or malignant. In conclusion, in radiation-exposed children, higher thyroglobulin levels indicated an increased risk of developing thyroid nodules but did not differentiate between benign and malignant neoplasms. There was no association between the baseline TSH level and the risk of developing thyroid nodules or cancer.

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Buyvalenko, U. V., A. R. Levshina, and E. E. Sakhnova. "Alternative biomarkers of thyroid cancer." Clinical and experimental thyroidology 18, no. 1 (July 11, 2022): 21–28. http://dx.doi.org/10.14341/ket12715.

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Serum thyroglobulin is the main biomarker for postoperative monitoring of papillary thyroid cancer recurrence however, the high prevalence of the disease dictates the need to find a reliable indicator for laboratory diagnosis of the tumor process. The presence of antibodies to thyroglobulin affects the prognosis of the disease and determines the likelihood of relapse; however, it is impossible to influence the level of antibodies using currently available methods. More commonly, trends in anti-thyroglobulin levels at the time of disease detection and after radical treatment are considered, but there is disagreement on the interpretation of the results. Currently, various alternative biomarkers are being proposed and studied, the evaluation and comparison of which will be the subject of this literature review.

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Lin, Jen-Der, Hong-So Huang, Shin-Cheh Chen, and Tzu-Chieh Chao. "Factors that Predict Metastasis of Papillary and Follicular Thyroid Cancers in Taiwan." Otolaryngology–Head and Neck Surgery 116, no. 4 (April 1997): 475–82. http://dx.doi.org/10.1016/s0194-59989770297-3.

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The purpose of this study is to explore the relationship of postoperative thyroglobulin level and other clinical factors with tumor metastasis. Analysis of 281 pathologic lesions verified patients with papillary and follicular thyroid cancer who received their primary treatment at Chang Gung Memorial Hospital. Clinical information—including postoperative thyroglobulin levels, age, sex, primary tumor size, clinical staging, surgical methods, surgical findings, chest x-ray findings, and 131I uptake—were stored in the computer. Actual survival rate and univariate and multivariate analyses of these factors with the relationship of distant metastases were undertaken. Twenty-three patients in this study died of distant metastases from the thyroid cancer. Of these patients, 30.4% were older than 60 years. In contrast only 8.5% of patients in the survival group were older than 60 years (p < 0.05 in χ 2 ). All of the papillary thyroid cancer patients with distant metastases displayed thyroglobulin levels higher than 25 ng/ml, but only 24% (41 of 173 cases) of those without distant metastases had thyroglobulin levels higher than 25 ng/ml. In 12 follicular thyroid cancer patients with distant metastases, 11 patients' serum thyroglobulin levels were higher than 25 ng/ml. In contrast, only 7 of 33 patients with follicular thyroid cancer without distant metastases displayed similar thyroglobulin levels. Univariate analysis revealed that age, postoperative thyroglobulin levels, chest x-ray findings, pathologic type, and tumor size are associated with distant metastases. One-month postoperative serum thyroglobulin level could be used as a prognostic factor for papillary and follicular thyroid cancer patients with distant metastases.

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Krahn, John, and Tom Dembinski. "Thyroglobulin and anti-thyroglobulin assays in thyroid cancer monitoring." Clinical Biochemistry 42, no. 4-5 (March 2009): 416–19. http://dx.doi.org/10.1016/j.clinbiochem.2008.12.017.

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Wang, Chih-Yuan, Wen-Bin Zhong, Tien-Chun Chang, Shu-Mei Lai, and Yuan-Feen Tsai. "Lovastatin, a 3-Hydroxy-3-methylglutaryl Coenzyme A Reductase Inhibitor, Induces Apoptosis and Differentiation in Human Anaplastic Thyroid Carcinoma Cells." Journal of Clinical Endocrinology & Metabolism 88, no. 7 (July 1, 2003): 3021–26. http://dx.doi.org/10.1210/jc.2002-021834.

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Although only 1% of differentiated thyroid cancers transform into anaplastic thyroid cancer, this disease is always fatal. Differentiation therapy may provide a new therapeutic approach to increasing the survival rate in such patients. 3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are reported to promote cellular apoptosis and differentiation in many cancer cells; these effects are unrelated to lipid reduction. Recently, we found that TNFα induces cytomorphological differentiation in anaplastic thyroid cancer cells and increases thyroglobulin expression; however, TNF is cytotoxic for normal human tissue. The aim of this study was to determine whether lovastatin, an HMG-CoA reductase inhibitor, could induce apoptosis and differentiation in anaplastic thyroid cancer cells. Anaplastic thyroid cancer cells were treated with lovastatin, then examined for cellular apoptosis and cytomorphological differentiation by DNA fragmentation, phosphatidylserine externalization/flow cytometry, and electron microscopy. Thyroglobulin levels in the culture medium were also measured. Our results showed that at a higher dose (50 μm), lovastatin induced apoptosis of anaplastic thyroid cancer cells, whereas at a lower dose (25 μm), it promoted 3-dimensional cytomorphological differentiation. It also induced increased secretion of thyroglobulin by anaplastic cancer cells. Our results show that lovastatin not only induces apoptosis, but also promotes redifferentiation in anaplastic thyroid cancer cells, and suggest that it and other HMG-CoA reductase inhibitors merit further investigation as differentiation therapy for the treatment of anaplastic thyroid cancer.

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Purizhansky, I. I., T. V. Ogneva, K. U. Kadyrov, Kh Yu Al-Sakhii, and A. P. Alyoshkin. "Clinical assessment of the data of radionuclide studies in the diagnosis of malignant tumors of the thyroid." Problems of Endocrinology 41, no. 2 (April 15, 1995): 17–19. http://dx.doi.org/10.14341/probl11365.

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A total of 386 patients with nodular goiter, compensated adenoma, lymphocytic thyroiditis, relapses of thyroid cancer, and metastases of thyroid cancer to regional lymph nodes were examined in order to assess the informative value of in vivo and in vitro radionuclide studies. In vivo studies were carried out using different systems of visual information processing gamma-chamber with 99mTc - pertechnetate, sodium iodide (131I, 123I) and 201Т1-chloride. Standard radioimmunoassay kits were used for measurements of blood serum levels of thyroxin, triiodothyronine, hypophyseal thyroid hormone, thyroglobulin and antibodies to it, parathyroid hormone, and calcitonin. 201Т1-chloride was found to be the optimal radionuclide for the differential diagnosis of tumors of the thyroid; as for the most informative in vitro test, thyroglobulin measurements should be preferred.

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Wingo, Susan T., Matthew D. Ringel, Jeffrey S. Anderson, Aneeta D. Patel, Yvonne D. Lukes, Yin-Ying Djuh, Barbara Solomon, et al. "Quantitative Reverse Transcription-PCR Measurement of Thyroglobulin mRNA in Peripheral Blood of Healthy Subjects." Clinical Chemistry 45, no. 6 (June 1, 1999): 785–89. http://dx.doi.org/10.1093/clinchem/45.6.785.

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Abstract Background: Thyroglobulin mRNA can be detected qualitatively in the peripheral blood of patients with metastatic thyroid cancer, thyroid cancer patients with residual thyroid bed uptake, and individuals with no known thyroid disease with intact thyroid glands by use of a lengthy, highly sensitive extraction technique. To improve and broaden the clinical usefulness of this assay, we developed a quantitative reverse transcription (RT)-PCR assay for thyroglobulin mRNA, using RNA recovered from whole blood with a simplified extraction technique. Methods: Whole blood was drawn from 32 healthy subjects in standard EDTA blood collection tubes. Total RNA was extracted from whole blood, using the PUREscript RNA Isolation Kit. RT-PCR using intron-spanning primers was used to quantitatively amplify thyroglobulin mRNA, using the ABI PRISM 7700 Sequence Detection System with a fluorescent-labeled, thyroglobulin-specific oligonucleotide probe. Thyroid RNA calibration curves were created using total RNA recovered from a single nondiseased thyroid gland. Results: Qualitative RT-PCR demonstrated the presence of thyroglobulin mRNA in the whole blood sample of each healthy subject. The mean concentration of thyroglobulin mRNA detected in these subjects was 433 ± 69 ng of total thyroid RNA per liter of whole blood (range, 26–1502 ng/L). Overall assay imprecision (CV) was 24% for five samples analyzed 10 times each in separate analytical runs on different days. Conclusions: Thyroglobulin mRNA can be accurately detected and quantified in peripheral blood from healthy subjects. This new quantitative technique may improve the clinical utility of circulating thyroglobulin mRNA detection in patients with thyroid disease.

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Cacho-Diaz, Bernardo, Daniel Cuevas-Ramos, Hector Spinola-Marono, Gervith Reyes-Soto, Eduardo Olvera-Manzanilla, Alejandro Monroy-Sosa, Nydia Arelly Lorenzana-Mendoza, Martin Granados-Garcia, and Angel Herrera-Gomez. "Thyroid Cancer Brain Metastases and Thyroglobulin." Journal of Endocrinology and Metabolism 6, no. 3 (2016): 90–94. http://dx.doi.org/10.14740/jem351w.

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Hjiyiannakis, P., J. Mundy, and C. Harmer. "Thyroglobulin Antibodies in Differentiated Thyroid Cancer." Clinical Oncology 11, no. 4 (August 1999): 240–44. http://dx.doi.org/10.1053/clon.1999.9056.

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Levy, Elliot G. "Thyroglobulin-Positive, Radioiodine-Negative Thyroid Cancer." Thyroid 11, no. 6 (June 2001): 599–602. http://dx.doi.org/10.1089/105072501750302921.

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Gemsenjäger, E. "Thyroglobulin-Positive, Radioiodine-Negative Thyroid Cancer." Thyroid 13, no. 8 (August 2003): 833–34. http://dx.doi.org/10.1089/105072503768499752.

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Nugraha, Gede Ketut Alit Satria, Putu Astawa, Made Bramantya Karna, I. Gede Eka Wiratnaya, and I. Wayan Juli Sumadi. "Increased thyroglobulin and receptor activator of nuclear factor kappa B ligand expression is a risk factor of bone metastasis on patients with thyroid cancer." International Journal of Research in Medical Sciences 9, no. 5 (April 28, 2021): 1244. http://dx.doi.org/10.18203/2320-6012.ijrms20211860.

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Background: Metastatic bone disease (MBD) of thyroid cancer poses increased risk of morbidity and mortality and significant decrease of quality of life of the patient, with 10 years survival rate of 40-70%. This study aims to find correlation between increased expression of thyroglobulin and receptor activator of nuclear factor kappa B ligand (RANKL) on thyroid cancer biopsy and increased risk of bony metastasis.Methods: This study use case control design to analyze the histopathologic preparation taken from biopsy of the patients with thyroid cancer from 2015 until 2020. The histopathology preparation was cut with 4 µm thickness, then analyzed through immunohistochemistry assay using thyroglobulin antibody cocktail and anti-RANKL polyclonal antibody by a pathologic anatomy consultant. Analysis and correlation between the high thyroglobulin and RANKL expression with the incidence of bony metastasis using chi-squared test and odd ratio calculation.Results: There is a significant difference of thyroglobulin and RANKL expression between the group with metastasis and without metastasis (p=0.05 and p=0.02, respectively). ROC curve analysis of thyroglobulin and RANKL expression resulted in the optimal cutoff value of both parameters. Thyroglobulin cutoff value was 1.70 and RANKL cutoff value was 1.95. The analysis showed significant correlation between high expression of thyroglobulin with the incidence of bony metastasis (p=0.044). Similar result was also found in the high expression of RANKL (p=0.02).Conclusions: Increased thyroglobulin and RANKL expression are a risk factor of bone metastasis on patients with thyroid cancer.

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Kahara, Toshio, Noboru Igarashi, Akira Hishinuma, Yuko Nakanishi, Akio Uchiyama, Atsuo Miwa, Shin Ishizawa, et al. "Thyroglobulin Gene Mutation with Cold Nodule on Thyroid Scintigraphy." Case Reports in Endocrinology 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/280319.

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Thyroglobulin gene mutation is a rare cause of congenital hypothyroidism, but thyroglobulin gene mutations are thought to be associated with thyroid cancer development. A 21-year-old Japanese man treated with levothyroxine for congenital hypothyroidism had an enlarged thyroid gland with undetectable serum thyroglobulin despite elevated serum TSH level. The patient was diagnosed with thyroglobulin gene mutation, with compound heterozygosity for Gly304Cys missense mutation and Arg432X nonsense mutation. Ultrasonography showed a hypovascular large tumor in the left lobe that appeared as a cold nodule on thyroid scintigraphy. He underwent total thyroidectomy, but pathological study did not reveal findings of thyroid carcinoma, but rather a hyperplastic nodule with hemorrhage. Strong cytoplasmic thyroglobulin immunostaining was observed, but sodium iodide symporter immunostaining was hardly detected in the hyperplastic nodule. The clinical characteristics of patients with thyroglobulin gene mutations are diverse, and some patients are diagnosed by chance on examination of goiter in adults. The presence of thyroid tumors that appear as cold nodules on thyroid scintigraphy should consider the potential for thyroid carcinoma, if the patient has relatively low serum thyroglobulin concentration in relation to the degree of TSH without thyroglobulin autoantibody.

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Rageh, Tarek M., Asmaa G. Abdou, Enas A. Elkhouly, Dalia H. Abou El- Ela, and Mohamed A. Zidan. "Preoperative significance of thyroglobulin, thyroid stimulating hormone and thyroglobulin antibody in differentiated papillary thyroid carcinoma." International Surgery Journal 6, no. 12 (November 26, 2019): 4229. http://dx.doi.org/10.18203/2349-2902.isj20195379.

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Background: The objective of the study was to compare the levels of preoperative thyroglobulin (TG), thyroid stimulating hormone level (TSH), FT3, FT4 and TG Ab among 50 malignant and 50 benign thyroid swellings. Papillary thyroid cancer (PTC) is the most common malignancy in thyroid gland. TG antibodies (Ab) occur in around 20% of patients with papillary thyroid cancer (PTC), and the presence of TG Ab complicates the follow-up of these patients because TG-Ab interferes with the assay of serum TG7.Methods: A prospective and retrospective study conducted on 100 patients with thyroid nodule diagnosed by neck ultrasound and confirmed by histopathological evaluation in Faculty of Medicine, Menoufia University Hospital, Egypt, during January 2017 to July 2019. History taking, levels of TG, TSH free T3, free T4 and TG Ab, neck ultrasound or CT and pathological evaluation were done.Results: There were statistically significant differences between malignant and benign thyroid swellings regarding, TG level, TSH and T4 level. Also, there was statistically significant difference between the level of TG and tumor recurrence (p=0.01). While, there was no statistical significance between focality, staging, lymph node status, capsular invasion, lymphovascular embolization, and evidence of hashimoto thyroiditis and the level of TG.Conclusions: Preoperative serum TG concentration is a useful marker for predicting the presence of initial distant metastasis of PTC and tumor recurrence. TSH level considered an important prognostic factor for papillary thyroid cancer patients.

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Hassan, Mir Mohammed Noorul, Prakash S. Kattimani, and Aeiman Saniya. "Preoperative serum thyroglobulin levels as a predictor of thyroid carcinoma." International Surgery Journal 7, no. 2 (January 27, 2020): 429. http://dx.doi.org/10.18203/2349-2902.isj20200040.

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Background: Incidence of thyroid nodules varies according to the methods of diagnosis, 4-7% by palpation and 17-67% by high resolution ultrasound. The gold standard of diagnosis for thyroid nodules is fine needle aspiration (FNA); however, fine needle aspiration cytology (FNAC) alone is insufficient to detect cancer because of inadequate cytology (5-15%) and in cases of follicular neoplasm (15-25%) where only surgery is diagnostically conclusive. Therefore, other factors in addition to FNA should be considered to predict malignancy. This study was done to evaluate the association between elevated pre-operative thyroglobulin levels and histopathologically proven thyroid carcinoma.Methods: This retrospective study was conducted in Bowring and Lady Curzon Hospital, from December 2017 to November 2018. All patients above 18 years, undergoing total thyroidectomy, with normal antithyroglobulin levels and with indeterminate thyroid nodules or disease on FNAC were included. Patients proven to have malignancy by FNAC, who underwent hemithyroidectomy and patients with thyroglossal cyst or ectopic thyroid swellings were excluded.Results: A total of 50 patients were included. The Fischer’s exact test shows significant value of 0.037 and also the two-tailed test showed a p value <0.05, hence it is significant to conclude that the mean value of thyroglobulin levels among histopathologically proven malignant thyroid cancers is significantly higher compared to the benign thyroid disease.Conclusions: In addition to thyroid-stimulating hormone, thyroid nodules with elevated thyroglobulin levels were independently associated with the presence of thyroid cancer; therefore, the evaluation of pre-operative thyroglobulin level in patients with indeterminate FNAC might give additional information to predict malignancy.

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Shim, Jien, Jianyu Rao, and Run Yu. "Spontaneous Regression of Metastatic Papillary Thyroid Cancer in a Lymph Node." Case Reports in Endocrinology 2018 (2018): 1–4. http://dx.doi.org/10.1155/2018/5873897.

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Spontaneous regression of cancer is defined as disappearance of cancer in the absence of specific therapy. In thyroid cancer patients with biochemically incomplete response to initial treatments, spontaneous decline in thyroglobulin levels without any cancer treatment is a well-known phenomenon; however, spontaneous regression of persistent or recurrent structural disease has not been reported. We here present a case of papillary thyroid cancer in a 58-year-old female who underwent total thyroidectomy and two radioiodine ablations. She had persistently elevated thyroglobulin levels. Six years after her initial treatments, she had biopsy-proven cervical lymph node metastasis. The patient opted not to undergo any further treatment. Over the course of the next 10 years, without any additional treatment, the lymph node disappeared and her thyroglobulin levels decreased to almost undetectable ranges, implying near-complete regression. Our case illustrates that metastatic papillary thyroid cancer in lymph nodes can regress spontaneously.

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Wilson, William A., Joseph Valentino, Thomas Gal, David Sloan, Kenneth B. Ain, Susanne M. Arnold, Yolanda Brill, and Mahesh R. Kudrimoti. "Excellent long-term control in locoregionally recurrent radioactive iodine-refractory papillary thyroid cancer with the addition of external beam radiation therapy to maximal surgical resection." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e16035-e16035. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e16035.

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e16035 Background: Locoregionally recurrent radioactive iodine (RAI) refractory papillary thyroid cancer represents a small percentage of papillary thyroid cancers but is an aggressive disease with significantly lower survival rates. This retrospective review is our experience with these cancers treated with maximal surgical resection followed by external beam radiotherapy. Methods: 26 patients treated from 2001-2011 were eligible for review. After obtaining IRB approval, medical records were reviewed for clinical outcome. All patients had histologically proven recurrences that were negative on I-131 scans. All patients were maximally resected. All patients received external radiotherapy to the thyroid bed, bilateral cervical lymph node levels II-IV, level VI, and superior mediastinal nodes. 15/26 patients received intensity modulated, 9/26 patients received 3-D conformal, and 2/26 patients received Tomotherapy radiation treatment. The mean dose was 5790 cGy (range 5280-6800 cGy). Results: All histologies were papillary thyroid cancer with 4/26 exhibiting tall cell features and 1/26 diffuse sclerosing features. All patients had locoregional relapse in the cervical nodes (16/26) or in the mediastinum (5/26) or both areas (5/26). The mean pre-treatment thyroglobulin was 5.2 (range <0.1 to 599.1). The mean post-treatment thyroglobulin was 1.0 (range <0.1-5.2). Median follow-up was 55 months (range 7-123 months). 0/26 patients failed locoregionally. 2/26 patients failed distantly (lungs). 20/26 patients (77%) of patients had undetectable thyroglobulin at last follow-up. 4/26 patients had detectable thyroglobulin (2.5-16.9), but had not recurred on imaging. 2/26 required PEG placement during treatment, but 0/26 patients were PEG-dependent on long-term follow-up. 1/26 patients experienced grade III osteoradionecrosis of the mandible. Conclusions: External beam radiotherapy provides excellent locoregional control for locoregionally recurrent radioactive iodine-refractory papillary thyroid cancers. Long-term grade III and IV toxicities are uncommon.

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Luo, Yuqian, Yuko Ishido, Naoki Hiroi, Norihisa Ishii, and Koichi Suzuki. "The Emerging Roles of Thyroglobulin." Advances in Endocrinology 2014 (April 10, 2014): 1–7. http://dx.doi.org/10.1155/2014/189194.

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Thyroglobulin (Tg), the most important and abundant protein in thyroid follicles, is well known for its essential role in thyroid hormone synthesis. In addition to its conventional role as the precursor of thyroid hormones, we have uncovered a novel function of Tg as an endogenous regulator of follicular function over the past decade. The newly discovered negative feedback effect of Tg on follicular function observed in the rat and human thyroid provides an alternative explanation for the observation of follicle heterogeneity. Given the essential role of the regulatory effects of Tg, we consider that dysregulation of normal Tg function is associated with multiple human thyroid diseases including autoimmune thyroid disease and thyroid cancer. Additionally, extrathyroid Tg may serve a regulatory function in other organs. Further exploration of Tg action, especially at the molecular level, is needed to obtain a better understanding of both the physiological and pathological roles of Tg.

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Gianoukakis, Andrew G. "Thyroglobulin antibody status and differentiated thyroid cancer." Current Opinion in Oncology 27, no. 1 (January 2015): 26–32. http://dx.doi.org/10.1097/cco.0000000000000149.

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Girelli, M. E., and D. De Vido. "Serum thyroglobulin measurements in differentiated thyroid cancer." Biomedicine & Pharmacotherapy 54, no. 6 (July 2000): 330–33. http://dx.doi.org/10.1016/s0753-3322(00)80058-x.

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Francis, Zélia, and Martin Schlumberger. "Serum thyroglobulin determination in thyroid cancer patients." Best Practice & Research Clinical Endocrinology & Metabolism 22, no. 6 (December 2008): 1039–46. http://dx.doi.org/10.1016/j.beem.2008.09.015.

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Peiris, Alan N., Dillon Medlock, and Meredith Gavin. "Thyroglobulin for Monitoring for Thyroid Cancer Recurrence." JAMA 321, no. 12 (March 26, 2019): 1228. http://dx.doi.org/10.1001/jama.2019.0803.

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Jeong, Chaiho, Jeongmin Lee, Hyukjin Yoon, Jeonghoon Ha, Min-Hee Kim, Ja-Seong Bae, Chan-Kwon Jung, Jeong-Soo Kim, Moo-Il Kang, and Dong-Jun Lim. "Serum CYFRA 21.1 Level Predicts Disease Course in Thyroid Cancer with Distant Metastasis." Cancers 13, no. 4 (February 15, 2021): 811. http://dx.doi.org/10.3390/cancers13040811.

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Background: Serum Cyfra 21.1, the soluble fragment of CK19, has been used as a prognostic tumor marker in various cancers, indicating poor tumor differentiation and increased metastasis. Methods: We analyzed the serum Cyfra 21.1 level in 51 consecutive patients with thyroid cancer manifesting distant metastasis treated with prior total thyroidectomy. Serum Cyfra 21.1 levels of 26 thyroid cancer patients without metastasis and 50 healthy individuals were used for comparison. Results: Higher serum Cyfra 21.1 levels were detected in thyroid cancer patients with distant metastasis compared with healthy subjects and thyroid cancer patients without metastasis (p = 0.012). Serum Cyfra 21.1 levels were significantly increased in patients with positive BRAF V600E mutation (p = 0.019), undergoing Tyrosine Kinase Inhibitor (TKI) therapy (p = 0.008), with radioiodine-refractory status (p = 0.047), and in disease progression compared with those manifesting stable disease (p = 0.007). In progressive disease with undetectable or unmonitored thyroglobulin because of thyroglobulin antibody, serum Cyfra 21.1 was useful as a biomarker for follow-up of disease course. Conclusion: Serum Cyfra 21.1 in thyroid cancer patients might represent an alternative biomarker predicting tumor progression, especially in cases not associated with serum Tg levels.

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Mikac, Gostimir, and Sinisa Stankovic. "Thyroglobulin value in patients surgically treated for differentiated thyroid carcinoma." Srpski arhiv za celokupno lekarstvo 144, no. 7-8 (2016): 397–401. http://dx.doi.org/10.2298/sarh1608397m.

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Introduction. Thyroglobulin is composed glycoprotein, and it is synthesized by follicular cells of the thyroid gland. Treatment of differentiated thyroid carcinomas involves total thyroidectomy followed by radioiodine ablation of a potential remaining tissue. The measurement of thyroglobulin in the postoperative follow-up can serve as an indicator of tumor growth or recurrence of the disease. Objective. The aim of this paper is to examine the value of thyroglobulin in patients surgically treated for differentiated thyroid cancer who had metastases in the lymph nodes of the neck, as well as in operated on patients without any evident metastasis. Methods. Thyroglobulin values in the serum of 58 patients were analyzed. Two groups were formed. The thyroglobulin value was established with the use of IRMA-hTg (125I) system. Normal levels of thyroglobulin were from 2 ng/ml to 65 ng/ml. For all of 58 patients, thyroglobulin was determined three times. The first, so-called pre-ablation thyroglobulin was determined immediately before the application of 131I ablation dose. The second and the third measurements were conducted six to eight months and one year, respectively, after the application of the ablation dose respectively. Results. The first group consisted of 14 patients with histologically proven metastases in the lymph nodes of the neck, while the second group consisted of 44 patients without any evident metastases. The average thyroglobulin value of pre-ablation in the patients from the first group was 43.45 ng/ml, while in the second was 7.57 ng/ml. Levene?s test (with p = 0.00, i.e p < 0.05), demonstrated a statistically significant difference. Furthermore, in both groups, there was statistically significant difference between pre-ablation and post-ablation thyroglobulin values (Student?s t-test with p < 0.05). Conclusion It can be concluded that the average value of thyroglobulin was significantly higher in patients with lymph node metastases in the neck. We are of the opinion that the determination of thyroglobulin, despite individual variations, may serve as a good indicator to assist in monitoring of patients surgically treated for differentiated thyroid cancer.

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Yazici, Pinar, Mehmet Mihmanli, Emre Bozkurt, Feyza Ozturk, and Mehmet Uludag. "Which is the best predictor of thyroid cancer: thyrotropin, thyroglobulin or their ratio?" HORMONES 15, no. 2 (June 26, 2016): 256–63. http://dx.doi.org/10.14310/horm.2002.1677.

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Toda, Soji, Hiroyuki Iwasaki, Nobuyasu Suganuma, Yoichiro Okubo, Hiroyuki Hayashi, Katsuhiko Masudo, Hirotaka Nakayama, and Munetaka Masuda. "Occult Thyroid Carcinoma without Malignant Thyroid Gland Findings during Preoperative Examination: Report of Three Cases." Case Reports in Endocrinology 2020 (April 10, 2020): 1–6. http://dx.doi.org/10.1155/2020/4249067.

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Occult thyroid carcinoma preceded by clinical manifestations and findings from extrathyroidal tumors is rare. The lack of malignant findings in the thyroid during the preoperative examination makes diagnosis difficult. We encountered a 71-year-old man with a primary ectopic thyroid carcinoma causing superior vena cava syndrome. Although no malignant findings were found in the thyroid gland, biopsy of bone metastases led to the diagnosis of thyroid cancer. HE staining of bone metastases revealed nuclear features of papillary carcinoma, and immunostaining was positive for thyroglobulin and PAX-8. The second case involved an 84-year-old man with a mediastinal tumor and suspected thyroid cancer because of high thyroglobulin levels in blood. The pathological tumor finding was papillary thyroid cancer. The last case was that of a 56-year-old woman lacking preoperative thyroid examination malignant findings, but with cervical lymph node metastasis. The thyroglobulin level of the lymph node puncture fluid was useful for preoperative diagnosis. We performed total thyroidectomy plus bilateral modified neck dissection. Pathology revealed a 1 mm papillary carcinoma in the left lobe. All of these cases were difficult to diagnose. However, we combined the results of various tests such as radiographic imaging, blood tests, and immunohistological tests to diagnose our patients.

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Ozmen, S., O. Timur, I. Calik, K. Altinkaynak, E. Simsek, H. Gozcu, A. Arslan, and A. Carlioglu. "Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer." Endocrine Regulations 51, no. 3 (July 1, 2017): 131–36. http://dx.doi.org/10.1515/enr-2017-0013.

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AbstractObjectives.NLR (neutrophil-lymphocyte ratio) and PLR (platelet-lymphocyte ratio) are prognostic markers of differentiated thyroid cancers. In our study, we evaluated NLR, PLR and C-reactive protein (CRP) for predicting the occurence of differentiated thyroid cancer. This is the first study that compares NLR and PLR to C-reactive protein indifferantiated thyroid cancer not only papillary cancer but also folliculer cancer.Methods.This study includes 51 papillary carcinoma, 42 papillary microcarcinoma and 31 folliculer carcinoma patients attending to our outpatient Endocrinology Clinic at Erzurum Region Training and Research Hospital between 2009 and 2014. The control group include 50 age, sex and body mass index matched healty subjects. Blood counts and CRP were measured at the day before surgery. Thyroglobulin was measured after 6 months of operation.Results.There were positive correlations between tumor diameter, age, white blood cell (WBC) and thyroglobulin levels. There were also positive correlation between NLR, PLR and CRP levels.Conclusion.In our study, we found out that higher NLR and PLR was associated with higher levels of thyroglobulin which indicates worse survival. CRP levels were also associated with poorer tumor profile but the determining rate was lower according to ROC analysis

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Wang, Hui, Shanshan Zhao, Chunyang Xu, Jincao Yao, Xiuhua Yu, and Dong Xu. "Clinical Value of Ultrasonography and Serum Markers in Preoperative N Staging of Thyroid Cancer." Cells 11, no. 22 (November 15, 2022): 3621. http://dx.doi.org/10.3390/cells11223621.

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We aimed to determine factors influencing lymph node metastasis (LNM) and develop a more effective method to assess preoperative N staging. Overall, data of 2130 patients who underwent thyroidectomy for thyroid cancer between 2018 and 2021 were retrospectively analysed. Patients were divided into groups according to pN0, pN1a, and pN1b stages. Pathology was used to analyse the correlation between preoperative serum marker indicators and LNM. Receiver operating characteristic curves were used to compare the diagnostic value of ultrasound (US) examination alone, serum thyroglobulin, age, and combined method for LNM. A significant moderate agreement was observed between preoperative US and postoperative pathology for N staging. Between the pN0 and pN1 (pN1a + pN1b) groups, the differences in free triiodothyronine, anti-thyroid peroxidase antibody, and serum thyroglobulin levels were statistically significant. Among the indicators, serum thyroglobulin was an independent predictor of LNM. The area under the receiver operating characteristic curve was 0.610 for serum thyroglobulin level for predicting LNM, 0.689 for US alone, and 0.742 for the combined method. Both preoperative US and serum thyroglobulin level provide a specific value when evaluating the N staging of thyroid cancer, and the combined method is more valuable in the diagnosis of LNM than US alone.

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Stanyakina, E. E., I. S. Romanov, E. Kh Gogieva, A. V. Ignatova, Yu V. Alymov, and K. D. Ilkaev. "The effectiveness of the method for determining the level of thyroglobulin in needle washouts of fine-needle aspiration biopsy in the differential diagnosis of metastases of highly differentiated thyroid cancer in the lymph nodes of the neck." Head and Neck Tumors (HNT) 12, no. 3 (December 13, 2022): 10–16. http://dx.doi.org/10.17650/2222-1468-2022-12-3-10-16.

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Introduction. Thyroid cancer is one of the most common malignant neoplasms of the endocrine system. well-differentiated thyroid cancer constitutes about 90 % of all malignant tumors of the thyroid gland. Despite growing morbidity and high incidence of this pathology, in case of timely diagnosis and treatment well-differentiated thyroid cancer has favorable prognosis.Aim. using clinical examples, to demonstrate the possibility of thyroglobulin measurement in needle washouts of fineneedle aspiration biopsy in the detection of cervical metastases of highly differentiated thyroid cancer.Materials and methods. five patients (2 patients with combined oncological pathology, 2 patients with nodes in the thyroid gland, 1 patient after a thyroidectomy) with cervical adenopathy measured the level of thyroglobulin in the wash out fluid of lymph-nodes biopsy using the immunoradiometric method using the commercial kits of the Institute of Isotopes-IRmA (Hungary).Results. Cervical metastases of highly differentiated thyroid cancer were detected or excluded by the determination of fine-needle aspiration biopsy in patients with non-informational cytological studies. The determination of fineneedle aspiration biopsy is a useful diagnostic method in the differential diagnosis of cervical metastases in patients who have other morphological forms of cancer in addition to well-differentiated thyroid cancer, as well as for the differential diagnosis of cervical adenopathy in patients with a history of highly differentiated thyroid cancer.Conclusion. Determination of thyroglobulin level in puncture needle washout is a simple and useful diagnostic method for differential diagnosis of metastases in lymph nodes of the neck in patients with several morphological forms of malignant tumors.

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Lin, Yansong, Tianjun Li, Jun Liang, Xiaoyi Li, Liheng Qiu, Shasha Wang, Yonghui Chen, Zengshou Kang, and Fang Li. "Predictive Value of Preablation Stimulated Thyroglobulin and Thyroglobulin/Thyroid-Stimulating Hormone Ratio in Differentiated Thyroid Cancer." Clinical Nuclear Medicine 36, no. 12 (December 2011): 1102–5. http://dx.doi.org/10.1097/rlu.0b013e3182291c65.

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Romero, Fabiola, Sandra Galeano, Francisco Cabrera, Liliana Vigo, Carlos Laterza, Oscar Codas Thompson, and Elizabeth Valinotti. "Utility of Stimulated Thyroglobulin in the Differentiate Thyroid Cancer." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A874. http://dx.doi.org/10.1210/jendso/bvab048.1786.

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Abstract Introduction: The treatment of differentiated thyroid cancer has changed considerably, total thyroidectomy and radioactive iodine ablation represented the initial treatment for these patients, currently with a great debate around the choice of which patient should undergo ablation with radioactive iodine in the post-surgical period. Objective: To determine the values of stimulated thyroglobulin (in hypothyroidism) in patients with differentiated thyroid carcinoma who have had surgery and its relationship with the ATA 2015 recurrence risk stratification and the presence of distant or locoregional metastasis in post ablative total body scan with I131 Methodology: Retrospective study, which included patients with differentiated thyroid carcinoma, patients who have had total thyroidectomy surgery and subsequent ablation with I131 in 45 days at the Central Hospital of Instituto de Prevision Social, from 2011 to 2018. There were evaluated: post-surgical thyroglobulin dosage in hypothyroidism, antithyroglobulin antibody measurement, and total body scan results at 72 hours post ablation with I131. There were excluded: Patients with positive antithyroglobulin antibodies, eu /hyperthyroidism, or incomplete data. Results: 100 patients conformed by women (88.0%), whose average age was 44.7 (± 16.1), intermediate risk 60%, high risk 31% and low risk 9%. According to the stimulated thyroglobulin values, 3 groups were classified: Group A thyroglobulin less than 1 ng/dl 32%, Group B 1 to 10 ng/dl 39%, Group C greater than 10 ng/dl 29%. Of the patients at intermediate risk n: 60, 23 (38%) belonged to group A, 27 (45%) to group B and 10 (17%) to group C. Of high-risk patients n: 31, 7 (22%) belonged to group A, 8 (26%) to group B, and 16 (52%) to group C. Of low risk patients n: 9, 2 (22%) belonged to group A, 4 (44%), group B, and 3 (33%) to group C. Post-ablative body scan detected locoregional or distant metastases in 23 (23%) patients, of which 2 (8.6%) belonged to group A, 6 (26%) to group B, 15 (65%) to group C. They were intermediate risk 10 (43%) and high risk 13 (57%) of them. No low-risk patient presented a positive RCT. There was found a relationship between thyroglobulin and high ATA risk (p <0.05) with positive RCT. Association between thyroglobulin> 10ng / dL and the presence of metastasis (p = 0.0001), Exp (B) 15.1 with R2 25 and 35%. Conclusion: A stimulated postoperative thyroglobulin dosage greater than 10 ng/ dL increases the chances of recurrence 15 times, with 25 to 37% chance of it. So, it would be important to consider ablation with iodine 131 in this type of patients.

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Carhill, Aubrey A., and Rena Vassilopoulou-Sellin. "Durable Effect of Radioactive Iodine in a Patient with Metastatic Follicular Thyroid Carcinoma." Case Reports in Endocrinology 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/231912.

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Objective. Thyroid cancer is the most common endocrine malignancy and fastest increasing of all cancers in both men and women in the United States. Traditionally, differentiated thyroid cancer (DTC) carries a good prognosis when diagnosed early, but increasingly patients are presenting with late-stage disease and bone metastasis which carries a poor prognosis. Treatment of DTC involves surgical resection followed by radioactive iodine (RAI), which conventionally is thought to reach maximal effectiveness between 6 and 12 months following treatment. We report a case and review the literature surrounding long-term effect of radioactive iodine treatment in metastatic thyroid carcinoma.Methods. Patient clinical encounter and the literature review.Results. We describe a 49-year-old woman with symptomatic metastatic follicular thyroid cancer (FTC) to the spine and radiographic evidence of spinal cord compression who was effectively treated with RAI. Her initial serum thyroglobulin (Tg) levels following total thyroidectomy were 1,343 ng/mL which dramatically dropped to less than 100 ng/mL following RAI. Forty-three months following treatment with RAI, she has experienced complete resolution of her symptoms and continues to maintain persistently low-thyroglobulin levels of less than 100 ng/mL.Conclusions. RAI is believed to reach peak efficacy within 6–12 months; however, little has been reported regarding the long-term duration of benefit. This case demonstrates that the benefits of RAI therapy may be enduring, even in patients with widely metastatic thyroid cancer. It suggests in clinically stable patients with declining thyroglobulin after treatment, that there may not be an immediate need for additional therapy as RAI treatment may provide lasting effects.

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Zelinskaya, Anna, Andrey Kvachenyuk, Galina Kulinichenko, and Victoria Moroz. "CYTOLOGICAL CHARACTERISTICS OF POSTOPERATIVE METASTASES OF PAPILLARY THYROID CANCER DURING THE DEVELOPMENT OF SECONDARY RADIOIODINE REFRACTORINESS." EUREKA: Life Sciences 1 (January 24, 2020): 3–10. http://dx.doi.org/10.21303/2504-5695.2020.001117.

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Radioiodine refractoriness is the main problem in the diagnosis and treatment of papillary thyroid carcinoma. The aim of the study was to investigate the cytological and immunocytochemical changes of thyrocytes in fine-needle aspiration smears of thyroid papillary cancer metastases in the course of the development of secondary radioiodine resistance. A total of 70 postoperative metastases of thyroid papillary cancer (secondary radioiodine refractory metastases, previously responsive to radioiodine, that eventually loses the ability to radioiodine accumulation, radioiodine-avid metastases, primary radioiodine-refractory metastases), immunohistochemical staining of thyroid peroxidase, thyroglobulin, cytokeratin 17 and cytological analysis were performed. Revealing the presence of specific cellular phenotypes and structures in punctuates, a low percentage of thyroid peroxidase and thyroglobulin-positive thyrocytes allows the development of the method of cytological prediction of the radioiodine therapy effectiveness.

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Ritter, Amit, Aviram Mizrachi, Gideon Bachar, Igor Vainer, Ilan Shimon, Dania Hirsch, Talia Diker-Cohen, Hadar Duskin-Bitan, and Eyal Robenshtok. "Detecting Recurrence Following Lobectomy for Thyroid Cancer: Role of Thyroglobulin and Thyroglobulin Antibodies." Journal of Clinical Endocrinology & Metabolism 105, no. 6 (March 27, 2020): e2145-e2151. http://dx.doi.org/10.1210/clinem/dgaa152.

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Abstract Background The use of thyroglobulin (Tg) and thyroglobulin antibodies (TgAb) for detecting disease recurrence is well validated following total thyroidectomy and radioiodine ablation. However, limited data are available for patients treated with thyroid lobectomy. Methods Patients who had lobectomy for papillary thyroid cancer followed for >1 year, with sufficient data on Tg and TgAb, including subgroup analysis for Hashimoto’s thyroiditis and contralateral nodules. Results One-hundred sixty-seven patients met the inclusion criteria. Average tumor size was 9.5 ± 6 mm. Following lobectomy, Tg was 12.1 ± 14.8 ng/mL. Of 52 patients with Hashimoto’s thyroiditis, 38% had positive TgAb with titers of 438 ± 528 IU/mL, and in patients without TgAb the mean Tg level was 14.7 ± 19.0 ng/mL. In 34 patients with contralateral nodules ≥1 cm, Tg was 15.3 ± 17 ng/mL. During the first 2 years of follow-up, Tg declined ≥1 ng/mL in 42% of patients (by 5.1 ± 3.7 ng/mL), remained stable in 22%, and increased in 36% (by 4.9 ± 5.7 ng/mL). During a mean follow-up of 6.5 years (78 ± 43.5 months), 18 patients had completion thyroidectomy and 12 were diagnosed with contralateral cancer (n = 8) or lymph node metastases (n = 4). In patients with recurrence followed for >2 years, there was a rise in Tg in 3 cases, Tg was stable in 2 cases, and in 1 TgAb decreased from 1534 to 276 IU/mL despite metastatic lymph nodes. Basal Tg and Tg dynamics did not predict disease recurrence. Conclusions Serum thyroglobulin used independently is of limited value for predicting or detecting disease recurrence following thyroid lobectomy. Other potential roles of Tg, such as detecting distant metastases following lobectomy, should be further studied.

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Dedov, Ivan I., Pavel O. Rumyantsev, Ksenia S. Nizhegorodova, Konstantin Y. Slashchuk, Valentina S. Yasyuchenya, Marina S. Sheremeta, Michail V. Degtyarev, Larisa V. Nikankina, and Galina A. Melnichenko. "Recombinant human thyrotropin in radioiodine diagnostics and radioiodine ablation of patients with well-differentiated thyroid cancer: the first experience in Russia." Endocrine Surgery 12, no. 3 (December 27, 2018): 128–39. http://dx.doi.org/10.14341/serg9806.

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Background. Traditional endogenous stimulation of thyroid-stimulating hormone (TSH) by means of long-term withdrawal of thyroid hormones for radioiodine diagnostics and radioiodine therapy causes severe hypothyroidism, which worsens patients’ general well-being and may lead to side effects and cause tumor growth and dissemination. Exogenous stimulation with recombinant human TSH (rh-TSH, thyrotropin-alfa) causes short-term increases in TSH levels and does not have the above-mentioned side effects. Purpose. To estimate the efficacy and safety of rh-TSH in preparation of patients with well-differentiated thyroid cancer for radioiodine diagnostics and radioiodine therapy. Methods. We conducted an interventional single-center prospective unblinded uncontrolled study of the efficacy and safety of thyrotropin-alfa to prepare patients with well-differentiated thyroid cancer to radioiodine diagnostics and post-surgery radioiodine ablation. The study included 88 patients with well-differentiated thyroid cancer: 54 patients were prepared for post-surgery radioiodine ablation; 34 patients – for radioiodine diagnostics to evaluate combined treatment efficacy and exclusion of tumor recurrence. The level of TSH, thyroglobulin, antibodies to thyroglobulin, whole body scintigraphy, and side effects were measured during exogenous stimulation with thyrotropin-alfa. Results. The level of TSH reached or exceed the target level (30 mIU/ml) 24 hours after the first injection of recombinant thyrotropin-alfa in 86% of patients; after 48 hours in 100%, the level exceeding 100 IU/ml was observed in 66 (75.1%) patients. The maximum levels of thyroglobulin and antibodies to thyroglobulin were reached 72 and 48 hours after the first injection, respectively. The injections of thyrotropin-alfa were well-tolerated by the patients. In the group for radioiodine diagnostics 2 (5.8%) patients complained of fatigue, 1 (2.9%) patient had signs of dyspeptic disorder, while in the group for radioiodine ablation 4 (7.4%) patients complained of fatigue, 1 (1.8%) patient had marked memory problems that disappeared later (they must have been caused by the patient’s advanced age (82 years)). Conclusions. Exogenous recombinant human thyroid-stimulating hormone (thyrotropin-alpha) is highly effective in preparation of patients with well-differentiated thyroid cancer for radioiodine diagnostics and radioiodine ablation. It does not have side effects, which are typical of withdrawal of thyroid hormones. The levels of thyroglobulin and antibodies to thyroglobulin measured 72 hours after the first injection of thyrotropin-alfa have the biggest diagnostic informative value.

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Coelho, Sabrina Mendes, Alexandru Buescu, Rossana Corbo, Denise P. Carvalho, and Mário Vaisman. "Recurrence of papillary thyroid cancer suspected by high anti-thyroglobulin antibody levels and detection of peripheral blood thyroglobulin mRNA." Arquivos Brasileiros de Endocrinologia & Metabologia 52, no. 8 (November 2008): 1321–25. http://dx.doi.org/10.1590/s0004-27302008000800019.

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The amplification of thyroglobulin (TG) mRNA in peripheral blood of patients with thyroid cancer has been studied for almost one decade, but its real contribution for diagnosis of cancer relapse has not yet been established. In the present paper we report the case of a patient with papillary thyroid cancer with undetectable stimulated serum thyrogobulin levels after thyroid ablation. Follow-up showed the presence of high titers of anti-thyroglobulin antibodies and the presence of TG mRNA in a peripheral blood sample, while cervical ultrasound and thorax and cervical computerized tomography were negative. Reinvestigation confirmed lymph node metastases. Anti-TG antibodies progressively decreased after surgery for metastatic lymph nodes resection followed by radioiodine therapy. Although our recent findings show that patients with positive TG mRNA do not have increased risk of cancer recurrence after 24 months of follow-up, the presence of TG mRNA along with high anti-TG antibodies were important indicators that determined further extensive investigation of tumour relapse in this patient, since positron emission tomography scan was not available at our Institution. A methodological standardization that can distinguish specific from non-specific TG mRNA amplification might be of great interest for the follow-up of differentiated thyroid cancer, especially in patients with high levels of anti-TG antibodies.

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Matthews, T. J., E. Chua, A. Gargya, J. Clark, K. Gao, and M. Elliott. "Elevated serum thyroglobulin levels at the time of ablative radioactive iodine therapy indicate a worse prognosis in thyroid cancer: an Australian retrospective cohort study." Journal of Laryngology & Otology 130, S4 (July 2016): S50—S53. http://dx.doi.org/10.1017/s0022215116008331.

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AbstractBackground:Serum thyroglobulin is used as a surrogate marker for well-differentiated thyroid carcinoma recurrence. This study investigates whether thyroglobulin measured at the time of ablative radioactive iodine therapy predicts disease-free survival.Methods:A retrospective review was conducted of patients with well-differentiated thyroid carcinoma presenting from 1989 to 2010 at the Royal Prince Alfred Hospital, New South Wales, Australia. Disease-free survival of patients with a significantly elevated stimulated thyroglobulin level (27.5 µg/l or higher) at the time of ablative radioactive iodine therapy was compared to that of patients without a significantly elevated thyroglobulin level using univariate analysis.Results:Patients with a thyroglobulin level of 27.5 µg/l or higher had an increased relative risk of disease recurrence of 4.50 (95 per cent confidence interval = 1.35–15.04). If lateral neck dissection was required at the time of surgery, patients also had an increased relative risk of macroscopic disease recurrence of 4.94 (95 per cent confidence interval = 1.47–16.55).Conclusion:An elevated thyroglobulin level of 27.5 µg/l or higher at the time of ablative radioactive iodine therapy is a prognostic indicator for macroscopic disease recurrence in well-differentiated thyroid carcinoma.

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Konrády, András, Zsuzsa Bencsik, Zoltán Lőcsey, and Tamás Bénik. "Outcome of differentiated thyroid cancer after initial treatment." Orvosi Hetilap 152, no. 43 (October 2011): 1731–38. http://dx.doi.org/10.1556/oh.2011.29227.

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Incidence of differentiated thyroid cancer has increased in the last two decades. This type of cancer is now being diagnosed at an earlier stage. Treatment strategy has been modified. Aims: The goals of this study were to analyze the outcome of differentiated thyroid cancer after initial treatment (surgery and radioiodine ablation) in patients evaluated and followed up in a single centre between l999 and 2009, to compare these results with others as well as to monitor the adoption of international recommendation. 107 patients having T1-T2 differentiated thyroid cancer were studied. Mean follow-up time was 63 months. Results: After surgery patients were prepared using thyroid hormone withdrawal or recombinant human thyrotropin, then 1.1-3.7 GBq 131-iodine was administered. First year evaluation consisted of ultrasound as well as serum thyrotropin and thyroglobulin (plus thyroglobulin antibody) determinations. Ablation success rate was 83% and the five year survival was 100%. There was not any cancer specific death. Conclusion: In the future somewhat more radical surgery and less remnant ablation is needed with unified follow-up protocol. Orv. Hetil., 2011, 152, 1731–1738.

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Ladenson, P. W. "Optimal laboratory testing for diagnosis and monitoring of thyroid nodules, goiter, and thyroid cancer." Clinical Chemistry 42, no. 1 (January 1, 1996): 183–87. http://dx.doi.org/10.1093/clinchem/42.1.183.

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Abstract Optimal use of laboratory tests to diagnose and monitor patients with goiter, thyroid nodules, or thyroid cancer requires an appreciation of the pathophysiologic factors implicated in thyroid hyperplasia and neoplasia: growth factors (especially thyrotropin, TSH), growth-stimulating immunoglobulins, activating mutations of the TSH receptor, and other oncogenic transformations. In patients with diffuse goiter and thyroid nodules, serum TSH measurement in a highly sensitive assay excludes both primary hypothyroidism and common causes of thyrotoxicosis. In selected patients, screening for anti-thyroid peroxidase with or without anti-thyroglobulin antibodies can confirm the diagnosis of autoimmune thyroiditis. Serum calcitonin measurement is appropriate only when medullary thyroid carcinoma (MTC) is clinically suspected. Laboratory testing is essential in management of thyroid carcinoma patients after primary surgical therapy. Serum TSH measurement is vital to ensure that thyroxine replacement and TSH suppression are adequate in treatment of epithelial cancers. Serial monitoring of serum thyroglobulin (Tg) can detect tumor recurrence and quantify tumor burden. Interpretation of serum Tg results requires an appreciation of certain technical considerations (e.g., anti-Tg antibody interference) and the patient's concurrent TSH status. Periodic serum Tg measurements and 131I scans are complementary monitoring techniques. Serum calcitonin measurement and screening for ret protooncogene mutations are both valuable for identifying individuals with MTC.

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Ponder, Michelle, Elizabeth Lamos, and Kashif Munir. "Two Cases of Armour Thyroid Interference in Thyroglobulin Monitoring for Thyroid Cancer." Case Reports in Endocrinology 2021 (November 17, 2021): 1–4. http://dx.doi.org/10.1155/2021/1152572.

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Thyroglobulin (Tg) monitoring is the biochemical standard for surveillance of recurrent differentiated thyroid cancer (DTC). Several assays are available to quantify Tg levels: immunometric assay (IMA), radioimmunoassay (RIA), and the newer liquid chromatography tandem mass spectrometry (LC-MS). It is well known that a number of entities can interfere with the accuracy of testing, and at this point in time, no one assay perfectly balances high sensitivity with low risk of interference. In this case study, we present two cases in which treatment with desiccated thyroid extract (Armour thyroid) led to a sudden elevation in Tg, which resolved when Armour thyroid was discontinued. This elevation occurred when Tg was measured with both IMA and LC-MS, which suggests direct interference from porcine Tg rather than heterophilic or thyroglobulin antibody (TgAb) interference. We suggest that patients with a history of DTC not be treated with desiccated thyroid extracts consistent with guidelines. Furthermore, more advances need to be made in the area of Tg testing to improve specificity and avoid detection of nonhuman Tg and other similar proteins.

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Faisal, Sobia, Waleed Ibrahim, and Canan Gunay. "PSAT278 A Curious Case of Thyroglossal Duct Cancer." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A811. http://dx.doi.org/10.1210/jendso/bvac150.1678.

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Abstract Introduction Thyroglossal duct (TGD) cyst is a common congenital anomaly. Thyroid cancer rarely occurs in TGD cysts, affecting less than 1% of cysts. Here we present a case of TGD cancer presenting as a central neck mass. Case Presentation 60 y.o female presented to her primary care physician with a neck mass without any compressive symptoms. She had no history of head/neck radiation exposure and no family history of thyroid cancer. She was noted to have a non-tender central neck mass with palpable cervical lymphadenopathy. Neck ultrasound revealed a 5.7 cm multilobulated cystic and solid mass anterior to the thyroid gland. CT scan of the neck revealed a lobulated mixed solid cystic mass at the level of the thyroid cartilage projecting anteriorly, with an abnormal right submandibular lymph node measuring 2.2×1.0 cm. She was evaluated by ENT and underwent resection of the neck mass and the hyoid bone (Sistrunk's procedure). Level 1b lymph node was also removed. Operative findings were concerning for a malignant process. This was confirmed on pathology with findings of TGD papillary thyroid cancer (PTC) and level 1b lymph node demonstrating metastatic PTC with cystic features. She was then referred to endocrine. Thyroid ultrasound revealed multiple bilateral intermediate suspicion nodules. Left inferior thyroid nodule was noted to have high suspicion sonographic features with abnormal right sided level 2 and 3 lymph nodes. She was referred for total thyroidectomy, pathology revealed multifocal PTC with lymph node involvement with extra nodal extension and metastasis to the left sternohyiod muscle, pT2, pN1b, AJCC stage 2. 6-week post-surgical labs revealed TSH of 1.69 mIU/L (ref range 0.40-4.50), thyroglobulin level of 0.8 ng/ml (ref range athyrotic <0.1), with undetectable thyroglobulin antibodies <1 IU/ml (ref range < or = 1 IU/mL). She underwent RAI with 104.6 mci. I-131 Metastatic survey revealed increased uptake in the thyroid bed, otherwise no increased activity elsewhere. Stimulated TSH and Thyroglobulin levels were done but not collected appropriately and therefore not mentioned here. Repeat labs 12 weeks after RAI revealed a TSH of 2.86 mIU/L, Thyroglobulin level of 0.2 ng/ml, and undetectable Thyroglobulin antibody. Conclusion There are no standardized guidelines for management of TGD cancer given the rarity of this condition. FNAB (Fine need aspiration biopsy) may be associated with high false negatives due to inadequate sampling, given the cystic nature of these lesions. In majority of these cases definitive diagnosis of cancer is made after excision of the TGD cyst. Some experts favor a conservative approach via Sistrunk's procedure and pursuing total thyroidectomy if there is high suspicion of thyroid gland involvement as well. Whereas other authors have suggested a more aggressive approach with total thyroidectomy even without evidence of concomitant involvement of the thyroid gland. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

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Žarković, Miloš. "Diagnosis of Thyroid Disease: Principles and Problems." Journal of Medical Biochemistry 29, no. 4 (October 1, 2010): 231–36. http://dx.doi.org/10.2478/v10011-010-0037-4.

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Diagnosis of Thyroid Disease: Principles and ProblemsConceptually, thyroid disorders can be classified into four groups, namely: 1. disorders of thyroid morphology, 2. disorders of thyroid function, 3. presence of thyroid autoimmunity, and 4. diagnosis and follow-up of thyroid carcinoma. Of course, these groups are non-exclusive, and often there is overlap between the groups. Ultrasound exam is a standard for the diagnosis of the disorders of thyroid morphology. To diagnose disorders of thyroid function TSH and thyroid hormones should be measured. Presence of thyroid autoimmunity is confirmed by measuring antibodies against thyroid-specific antigens. Thyroid peroxidase (TPO), thyroglobulin (Tg) and TSH receptors antibodies are used in the diagnosis, follow-up and prognosis of autoimmune thyroid disorders. The measurement of serum thyroglobulin has no role in the diagnosis of thyroid cancer, but it is used in the follow-up of patients treated for differentiated thyroid carcinoma of the follicular epithelium. Medullary thyroid cancer (MTC) produces calcitonin and carcinoembryonic antigen (CEA), but calcitonin is specific for MTC. In subjects with MTC, genetic testing should be done, and in positive cases family screening is necessary.

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Warda, Firas, Sam Ho, Enoch Kuo, Dinesh Rao, and Marilu Jurado-Flores. "Aggressive Papillary Thyroid Carcinoma Presenting with Metastasis to the Pancreas." Case Reports in Endocrinology 2022 (January 20, 2022): 1–5. http://dx.doi.org/10.1155/2022/5355419.

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Papillary thyroid cancer is the most common type of thyroid cancer. Aggressive forms tend to metastasize to the lungs and bones, but the abdomen is a rare site of metastasis. We present a 46-year-old male patient who presented with a neck mass associated with shortness of breath and hemoptysis. He was found to have a large thyroid mass on imaging. He underwent a total thyroidectomy with bilateral neck dissection, with pathology showing a multifocal tall cell variant of papillary thyroid carcinoma with lymphovascular invasion in both thyroid lobes. Due to recurrent findings of residual thyroid tissue on whole-body scan imaging, the patient underwent radioactive iodine ablation therapy twice, with poor response to therapy, suggested by persistently elevated thyroglobulin levels. However, the residual tissue responded to external beam radiation. After the initial response to radiation, thyroglobulin was noted to have increased again, prompting a PET-CT after administration of recombinant TSH. PET showed a focal area of increased uptake in the head of the pancreas. The patient underwent the Whipple procedure for resection of the metastasis. Pathology showed papillary thyroid carcinoma with strong and diffuse staining for TTF-1 and thyroglobulin. The patient was started on lenvatinib in the postoperative period and is currently tolerating treatment well with evidence of decreasing thyroglobulin levels. Intra-abdominal metastasis from a thyroid malignancy source is quite rare and can be challenging as far as diagnosis and treatment. Surgical resection can be curative and can be followed by radioactive iodine ablation therapy if cancer cells show avidity. Tyrosine kinase inhibitors can be used in refractory disease. New research is being conducted on new agents that can reverse the resistance to radioactive iodine therapy.

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Celano, Marilena, Francesca Rosignolo, Valentina Maggisano, Valeria Pecce, Michelangelo Iannone, Diego Russo, and Stefania Bulotta. "MicroRNAs as Biomarkers in Thyroid Carcinoma." International Journal of Genomics 2017 (2017): 1–11. http://dx.doi.org/10.1155/2017/6496570.

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Optimal management of patients with thyroid cancer requires the use of sensitive and specific biomarkers. For early diagnosis and effective follow-up, the currently available cytological and serum biomarkers, thyroglobulin and calcitonin, present severe limitations. Research on microRNA expression in thyroid tumors is providing new insights for the development of novel biomarkers that can be used to diagnose thyroid cancer and optimize its management. In this review, we will examine some of the methods commonly used to detect and quantify microRNA in biospecimens from patients with thyroid tumor, as well as the potential applications of these techniques for developing microRNA-based biomarkers for the diagnosis and prognostic evaluation of thyroid cancers.

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Koch, Linda. "Postablative thyroglobulin levels predict recurrence of thyroid cancer." Nature Reviews Endocrinology 6, no. 12 (November 23, 2010): 653. http://dx.doi.org/10.1038/nrendo.2010.178.

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Rössing, Ronja Maria, Walter Jentzen, James Nagarajah, Andreas Bockisch, and Rainer Görges. "Serum Thyroglobulin Doubling Time in Progressive Thyroid Cancer." Thyroid 26, no. 12 (December 2016): 1712–18. http://dx.doi.org/10.1089/thy.2016.0031.

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Journal articles on the topic 'Thyroid cancer, Thyroglobulin'

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