Thyroglobulin as early prognostic marker to predict remission at 18-24 months in differentiated thyroid carcinoma
Por:
Gonzalez, C, Aulinas, A, Colom, C, Tundidor, D, Mendoza, L, Corcoy, R, Mato, E, Alcantara, V, Rull, EU, de Leiva, A
Publicada:
1 feb 2014
Resumen:
IntroductionThyroglobulin (Tg), the most common marker to determine remission of differentiated thyroid carcinoma (DTC), can take 18months or longer to be undetectable. We hypothesized that Tg stimulated after surgery and immediately before radioiodine treatment (baseline-stimulated Tg) could be a good predictor of remission at 18-24months. The aim of this study was to evaluate the role of baseline-stimulated Tg as early prognostic marker of DTC.
Patients and methodsRetrospective study of 133 patients with DTC from 1998 to 2010 (age at diagnosis 474168, follow-up 50932years). Initial subset analysis was performed after excluding patients with positive TgAb, who were later included in the second. Baseline-stimulated Tg was divided into tertiles. Multivariate logistic regression analysis included baseline Tg and other known prognostic markers and receiver operating characteristic (ROC) curve to identify the best cut-off level of baseline Tg were performed.
ResultsBaseline-stimulated Tg in the highest tertile was the only predictive variable of persistence of disease at 18-24 months in the initial analysis (OR 453, P<001). In the second analysis, the predictive variables were baseline-stimulated Tg (OR 396, P<0001), presence of TgAb (OR 234, P<0005) and uptake outside of the thyroid bed post-treatment whole body scan (WBS; OR 53, P<005) were predictive of persistence of disease. The ROC curve showed that baseline-stimulated Tg below 855g/l identified 95% of disease-free patients at 18-24months after initial treatment.
ConclusionsBaseline-stimulated Tg is a good predictor of remission of disease at 18-24months after initial treatment and could be a useful marker to stratify risk immediately after surgery.
Filiaciones:
Gonzalez, C:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
CIBER BBN EDUAB HSP Grp, Biomed Res Networking Ctr Bioengn Biomat & Nanome, Barcelona, Spain
Aulinas, A:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Colom, C:
Dos de Maig Hosp, Endocrinol Unit, Barcelona, Spain
Tundidor, D:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Mendoza, L:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Corcoy, R:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
CIBER BBN EDUAB HSP Grp, Biomed Res Networking Ctr Bioengn Biomat & Nanome, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, E-08193 Barcelona, Spain
Mato, E:
CIBER BBN EDUAB HSP Grp, Biomed Res Networking Ctr Bioengn Biomat & Nanome, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, E-08193 Barcelona, Spain
Alcantara, V:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Rull, EU:
Hosp Santa Creu & Sant Pau, Dept Clin Biochem, Barcelona, Spain
de Leiva, A:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
CIBER BBN EDUAB HSP Grp, Biomed Res Networking Ctr Bioengn Biomat & Nanome, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, E-08193 Barcelona, Spain
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