Undetectable pre-ablation thyroglobulin levels in patients with differentiated thyroid cancer: it is not always what it seems

Arq Bras Endocrinol Metabol. 2013 Jun;57(4):300-6. doi: 10.1590/s0004-27302013000400004.

Abstract

Objective: To establish the frequency of U Tg (undetectable pre-ablation thyroglobulin) in TgAb- negative patients and to evaluate the outcome in the follow-up.

Subjects and methods: We retrospectively reviewed 335 patients' records. Twenty eight patients (9%) had U Tg. Mean follow-up was 42 ± 38 months. All subjects had undergone total thyroidectomy, and lymph nodes were positive in 13 (46%) patients. Tg and TgAb levels were measured 4 weeks after surgery by IMA technology in hypothyroid state. No evidence of disease (NED) status was defined as undetectable (< 1 ng/mL) stimulated Tg and negative Tg-Ab and/or negative WBS, together with normal imaging studies.

Results: Seventeen patients (61%) were considered with NED. Four patients (14%) had persistent disease (mediastinum, n = 1, lung n = 2, unknown n = 1), and 7 (25%) had detectable TgAb by other method during their follow-up.

Conclusions: U Tg levels usually is associated to a complete surgery. However, in a low percentage of patients, this may be related to false negative Tg or TgAb measurement.

MeSH terms

  • Ablation Techniques
  • Adult
  • Aged
  • Biomarkers, Tumor / blood*
  • Carcinoma, Papillary / blood*
  • Carcinoma, Papillary / classification
  • Cell Differentiation*
  • False Negative Reactions
  • Female
  • Follow-Up Studies
  • Humans
  • Lymph Nodes / pathology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thyroglobulin / blood*
  • Thyroglobulin / immunology
  • Thyroid Gland / surgery*
  • Thyroid Neoplasms / blood*
  • Thyroid Neoplasms / classification
  • Treatment Outcome

Substances

  • Biomarkers, Tumor
  • Thyroglobulin