ISSN: 1859 - 2872
Clinical characteristics of post-operative differentiated thyroid cancer patients with elevated serum thyroglobulin and negative 131I whole body scan
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Abstract
Objective: To determine the clinical characteristics of post-operative differentiated thyroid cancer (DTC) patients with elevated serum thyroglobulin (Tg) and negative 131I whole body scan (WBS). Subject and method: We conduct a cross-sectional descriptive study of 109 post-surgical DTC patient with elevated Tg and negative 131I WBS. Patients’ clinical and paraclinical parameters, ATA risk stratification were investigated. Result: Patients were mainly in stage I
(56.9%) and stage IV (37.6%) with cervical lymph node metastasis distant metastasis rates were 74.3% and 10.1%, respectively. High and intemediate ATA risk for recurrence were seen in majority of patients with rates of 53.2 and 40.4%, respectively. Median and mean serum Tg levels were 217 and 297.9ng/ml. Males and patients with high ATA risk for recurrence had higher mean serum Tg levels than females and patients with low to intermediate risk. Suspected lesions were found in 62.4% of patiens by neck ultrasound, mainly in levels IV and II neck nodes. Conclusion: In this study, most of post-operative DTC patients with elevated Tg and negative 131I WBS had high and intermediate ATA recurrent risk and untrasound-suspected cervical nodes in levels IV and II.
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2. Basu S, Dandekar M, Joshi A, D'Cruz A (2015) Defining a rational step-care algorithm for managing thyroid carcinoma patients with elevated thyroglobulin and negative on radioiodine scintigraphy (TENIS): Considerations and challenges towards developing an appropriate roadmap. Eur J Nucl Med Mol Imaging 42: 1167-1171.
3. Durante C, Haddy N, Baudin E, Leboulleux S et al (2006) Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: Benefits and limits of radioiodine therapy. J Clin Endocrinol Metab 91(8): 2892-2899.
4. Ahuja AT, Ying M, Ho SY et al (2008). Ultrasound of malignant cervical lymph nodes. Cancer Imaging 8: 48-56.
5. Na SJ, Yoo IR, O JH et al (2012) Diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in differentiated thyroid cancer patients with elevated thyroglobulin and negative 131I whole body scan: evaluation by thyroglobulin level. Ann Nucl Med 26: 26-34.
6. Vural GU, Akkas BE, Erkamak N et al (2012) Prognostic significance of FDG PET/CT on the follow-up of patients of differentiated thyroid carcinoma with negative 131-I whole-body scan and elevated thyroglobulin levels correlation with clinical and histopathologic characteristics and long-term follow-up data. Clin Nucl Med 37: 953-959.
7. Choi SJ, Jung KP, Lee SS et al (2016) Clinical usefulness of F-18 FDG PET/CT in papillary thyroid cancer with negative radioiodine scan and elevated thyroglobulin level or positive anti-thyroglobulin antibody. Nucl Med Mol Imaging 50: 130-136.
8. Mazzaferri EL, Jhiang SM (1994) Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 97(5): 418-428.
9. Giovanella L, Trimboli P, Verburg FA et al (2013) Thyroglobulin levels and thyroglobulin doubling time independently predict a positive 18F-FDG PET/CT scan in patients with biochemical recurrence of differentiated thyroid carcinoma. Eur J Nucl Med Mol Imaging 40: 874-880.
10. Bertagna F, Bosio G, Biasiotto G et al (2009) F-18 FDG-PET/CT evaluation of patients with differentiated thyroid cancer with negative I-131 total body scan and high thyroglobulin level. Clin Nucl Med 34: 756-761.
11. Polachek A, Hirsch D, Tzvetov G et al (2011) Prognostic value of post-thyroidectomy thyroglobulin levels in patients with differentiated thyroid cancer. J Endocrinol Invest 34(11): 855-860.
12. Spriano G, Ruscito P, Pellini R et al (2009) Pattern of regional metastases and prognostic factors in differentiated thyroid carcinoma. Acta Otorhinolaryngol Ital 29(6): 312-316.
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