Mutsuddy Pupree, Jeon Subin, Yoo Su Woong, Zhang Yingjie, Chowdhury Md Sunny Anam, Kim Jahae, Song Ho-Chun, Bom Hee-Seung, Min Jung-Joon, Kwon Seong Young
Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Jeonnam, Republic of Korea.
National Institute of Nuclear Medicine and Allied Sciences, Bangladesh Atomic Energy Commission, Dhaka, Bangladesh.
Medicine (Baltimore). 2020 Apr;99(14):e19652. doi: 10.1097/MD.0000000000019652.
Although serum thyroglobulin (Tg) is a reliable differentiated thyroid carcinoma (DTC) prognostic marker, its cutoff values can be affected by TSH stimulation status. Serum Tg prognostic values measured at different time points before and after radioactive iodine (RAI) therapy prepared with recombinant human TSH (rhTSH) in DTC patients, were investigated.This study included 160 DTC patients who underwent surgery followed by rhTSH-aided RAI therapy. Their serum Tg levels were measured 7 days before (D-7Tg), on the day of (D0Tg), and 2 days after (D2Tg) the RAI therapy. For response evaluation, the patients were classified into 2 groups: acceptable response and non-acceptable response (non-AR). Optimal Tg level cutoff values measured at different time points were evaluated for persistent or recurrent disease (PRD) prediction, as well as therapeutic response.Multivariate analysis showed that D-7Tg, D0Tg, and D2Tg significantly predicted non-AR (P < .05, for all). Optimal Tg level cutoff values for non-AR prediction were 0.6, 2.6, and 3.7 ng/mL for D-7Tg, D0Tg, and D2Tg, respectively. Cox regression analysis showed that Tg levels were significantly associated with PRD free survival with D-7Tg, D0Tg, and D2Tg cutoff values of 0.8, 4.0, and 6.0 ng/mL, respectively (D-7Tg, P = .010; D0Tg, P = .005; D2Tg, P = .011).Serum Tg levels measured at the different time points could predict PRD free survival as well as therapeutic response with different cutoff values in DTC patients who underwent rhTSH-aided RAI therapy.
尽管血清甲状腺球蛋白（Tg）是一种可靠的分化型甲状腺癌（DTC）预后标志物，但其临界值会受到促甲状腺激素（TSH）刺激状态的影响。本研究调查了DTC患者在接受重组人促甲状腺激素（rhTSH）辅助放射性碘（RAI）治疗前后不同时间点测得的血清Tg预后价值。本研究纳入了160例接受手术并随后接受rhTSH辅助RAI治疗的DTC患者。在RAI治疗前7天（D - 7Tg）、治疗当天（D0Tg）和治疗后2天（D2Tg）测量他们的血清Tg水平。为了进行反应评估，将患者分为两组：可接受反应组和不可接受反应组（非AR）。评估了在不同时间点测得的最佳Tg水平临界值对持续性或复发性疾病（PRD）的预测以及治疗反应。多因素分析表明，D - 7Tg、D0Tg和D2Tg均能显著预测非AR（所有P均<0.05）。D - 7Tg、D0Tg和D2Tg预测非AR的最佳Tg水平临界值分别为0.6、2.6和3.7 ng/mL。Cox回归分析表明，Tg水平与PRD无进展生存期显著相关，D - 7Tg、D0Tg和D2Tg的临界值分别为0.8、4.0和6.0 ng/mL（D - 7Tg，P = 0.010；D0Tg，P = 0.005；D2Tg，P = 0.011）。在接受rhTSH辅助RAI治疗的DTC患者中，不同时间点测得的血清Tg水平可以用不同的临界值预测PRD无进展生存期以及治疗反应。
