Preablative stimulated thyroglobulin correlates to new therapy response system in differentiated thyroid cancer.

Preablative stimulated thyroglobulin correlates to new therapy response system in differentiated thyroid cancer.

J Clin Endocrinol Metab. 2016 Jan 20;:jc20154016

Authors: Yang X, Liang J, Li T, Zhao T, Lin Y

Abstract
CONTEXT: Studies suggested a potential value of preablative stimulated Tg (ps-Tg) on predicting the recurrent and persistent diseases of differentiated thyroid cancer (DTC), whereas its correlations with therapeutic response remain uncertain.
OBJECTIVE: To establish the correlation between ps-Tg and therapeutic response proposed in 2015 American Thyroid Association (ATA) guidelines, and calculate a cut-off ps-Tg threshold for predicting a poor response.
DESIGN/SETTING: Patients who underwent total thyroidectomy and radioactive iodine (RAI) therapy in a University hospital participated in this retrospective study.
PATIENTS: Totally, 452 DTC patients were followed for a median of 38 months and were divided into three groups in terms of ps-Tg level: Group1:<1ng/ml (n=82), Group2: 1-10ng/ml (n=173), Group3:≥10ng/ml (n=197).
MAIN OUTCOME MEASURE: Clinical outcomes were assessed based on response to therapy re-staging system, dividing response into excellent (ER), indeterminate (IDR), biomedical incomplete (BIR), and structural incomplete (SIR).
RESULTS: Therapeutic responses could be obviously distinguished by different ps-Tg strata. SIR was identified in none of Group 1, 1.73% of Group 2, and 42.74% of Group 3, respectively ((2)=123.037, p<0.001). A cut-off value of ps-Tg at 26.75 ng/ml was obtained by receiver operating characteristic (ROC) curve for differentiating SIR from either ER, IDR, or BIR. The area under curve (AUC) was 0.947 and negative predictive value (NPV) was 96.99%. Ps-Tg was an independent predictive variable of SIR (OR: 42.312, p<0.001).
CONCLUSIONS: Ps-Tg has a great performance in predicting therapeutic response and providing incremental value for decision making of RAI therapy, especially for patients with high ps-Tg level.

PMID: 26789779 [PubMed - as supplied by publisher]

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