Department of Surgery, Nepean Clinical School, University of Sydney, Penrith, Australia.
The Whiteley-Martin Research Centre, Discipline of Surgery, University of Sydney, Penrith, Australia.
Thyroid. 2020 Nov;30(11):1601-1612. doi: 10.1089/thy.2019.0368. Epub 2020 Jun 10.
Serum thyroglobulin (Tg) is used in the follow-up of patients with differentiated thyroid cancers (DTC), but the presence of antithyroglobulin antibodies (TgAbs) makes Tg measurements unreliable. TgAb decline after total thyroidectomy and persistent/increasing levels may indicate cancer persistence/recurrence. Hence, we aimed to determine whether TgAb might be a reliable prognostic marker for DTC. We conducted a meta-analysis and systematic review. A comprehensive literature search was performed to identify studies of patients with DTC with known TgAb status and prognostic outcomes in five databases (Medline, Embase, PubMed, Google Scholar, and Scopus). We used a random-effects model to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs) for TgAb status and its association with DTC prognosis. After analysis of 34 studies, we found that TgAb+ patients have a higher risk of lymph node metastasis (OR = 1.18 [CI 1.47-2.25]) and cancer persistence/recurrence (OR = 2.78 [CI 1.55-4.98]) than TgAb- patients. However, no significant differences in mean/median tumor size, risk of extrathyroidal extension, tumor multifocality, and cancer mortality were found between the two groups. In a comparison of TgAb trends, patients with persistent/increasing TgAb levels were found to have a higher risk of cancer persistence/recurrence (OR = 9.90 [CI 4.36-22.50]) and cancer mortality (OR = 15.18 [CI 2.99-77]) than patients with decreasing TgAb levels. TgAb positivity and persistent/increasing trends were associated with compromised DTC prognosis. These results suggest that TgAb may be used as a prognostic marker in the follow-up of patients with DTC.
血清甲状腺球蛋白（Tg）用于随访分化型甲状腺癌（DTC）患者，但抗甲状腺球蛋白抗体（TgAb）的存在会使 Tg 测量结果不可靠。甲状腺全切除术后 TgAb 下降，持续/升高水平可能表明癌症持续存在/复发。因此，我们旨在确定 TgAb 是否可能成为 DTC 的可靠预后标志物。我们进行了一项荟萃分析和系统评价。在五个数据库（Medline、Embase、PubMed、Google Scholar 和 Scopus）中进行了全面的文献检索，以确定已知 TgAb 状态和预后结果的 DTC 患者的研究。我们使用随机效应模型计算 TgAb 状态及其与 DTC 预后的关联的汇总优势比（OR）和 95%置信区间（CI）。分析了 34 项研究后，我们发现 TgAb+患者发生淋巴结转移（OR=1.18[CI 1.47-2.25]）和癌症持续存在/复发（OR=2.78[CI 1.55-4.98]）的风险高于 TgAb-患者。然而，两组之间在平均/中位肿瘤大小、甲状腺外延伸风险、肿瘤多灶性和癌症死亡率方面无显著差异。在 TgAb 趋势比较中，发现持续/升高 TgAb 水平的患者发生癌症持续存在/复发（OR=9.90[CI 4.36-22.50]）和癌症死亡率（OR=15.18[CI 2.99-77]）的风险高于 TgAb 降低的患者。TgAb 阳性和持续/升高趋势与 DTC 预后受损有关。这些结果表明，TgAb 可作为 DTC 患者随访的预后标志物。
