University of Southern California, Los Angeles, CA, USA.
Best Pract Res Clin Endocrinol Metab. 2013 Oct;27(5):701-12. doi: 10.1016/j.beem.2013.07.003. Epub 2013 Aug 12.
Thyroglobulin autoantibodies (TgAb) are detected at diagnosis or during treatment in approximately 25% of patients with differentiated thyroid cancer (DTC). When present, TgAb interferes with thyroglobulin (Tg) measurement causing falsely low or undetectable Tg immunometric assay (IMA) values that can mask disease. Guidelines mandate that every Tg test have TgAb measured simultaneously and quantitatively by immunoassay and not a recovery test. The propensity and magnitude of TgAb-Tg interference relates to both Tg and TgAb concentrations and the class of Tg method used. Because the TgAb trend reflects changes in thyroid tissue mass, TgAb concentrations serve as a surrogate post-operative DTC tumor marker. A rising, or de novo appearance of TgAb may indicate recurrence, whereas a progressive decline suggests successful treatment. This review focuses on the technical limitations of current TgAb methods, characteristics of TgAb interference with different classes of Tg method, and the clinical value of monitoring TgAb trends as a surrogate DTC tumor marker.
甲状腺球蛋白自身抗体（TgAb）在约 25%的分化型甲状腺癌（DTC）患者的诊断或治疗期间被检测到。当存在时，TgAb 会干扰甲状腺球蛋白（Tg）的测量，导致 Tg 免疫测定法（IMA）值出现假性低值或无法检测到，从而掩盖疾病。指南要求每个Tg 检测都同时通过免疫测定法而非恢复试验定量测量 TgAb。TgAb-Tg 干扰的倾向和程度与 Tg 和 TgAb 浓度以及使用的 Tg 方法类别有关。由于 TgAb 趋势反映了甲状腺组织质量的变化，因此 TgAb 浓度可作为术后 DTC 肿瘤标志物的替代物。TgAb 的升高或新出现可能表明复发，而逐渐下降则表明治疗成功。本文重点介绍了当前 TgAb 方法的技术局限性、不同 Tg 方法类别中 TgAb 干扰的特征，以及监测 TgAb 趋势作为 DTC 肿瘤标志物替代物的临床价值。
