Department of Endocrine Surgery, Royal Victoria Hospital, Belfast, UK -
Department of Endocrine Surgery, Royal Victoria Hospital, Belfast, UK.
Minerva Endocrinol (Torino). 2024 Mar;49(1):60-68. doi: 10.23736/S2724-6507.23.03939-8. Epub 2023 Jul 10.
Twenty-twenty-five percent of patients with differentiated thyroid cancer (DTC) can have elevated thyroglobulin antibodies (TgAb). The study aimed to find any prognostic significance of elevated TgAb during follow-up.
Ten-year retrospective study from a tertiary center including 79 patients with raised TgAb after total/staged thyroidectomy for DTC. We identified patients with stable (7.6%), increasing (15%) and decreasing levels of TgAb (77.2%); groups 1, 2 and 3 respectively. During follow-up we analyzed TgAb in subcategories by TgAb trend (>50% rise, <50% rise, >50% decline, <50% decline, positive to negative/normalization, negative to positive and stable levels), gender, age, surgery, autoimmune disease, histology, RAI uptake, distant metastases, and recurrence.
The incidence of raised TgAb levels was 33.2%, with female predominance. No connection was identified regarding other parameters. 11.4% had distant metastases. The highest mean maximum levels of TgAb was in group 2 (1918.75 IU/mL) and the lowest in group 3 (412.70 IU/mL). The recurrence rate changed significantly between the 3 groups: 50% in group 1, 75% in group 2, and 25% in group 3 (P=0.002). Recurrence rates decreased to 15% in the subcategory where TgAb became negative/normal from positive (P=0.0001). In patients with a negative to positive TgAb level trend or >50% rise, recurrence rates were 100% (P=0.041) and 70% (P=0.012) respectively.
Patients with increasing TgAb levels during follow-up have a higher rate of recurrence, distinctly for those with negative to positive trend and >50% rise in TgAb. These patients need closer follow-up, and TgAb may be used as a dynamic follow-up marker.
25%分化型甲状腺癌（DTC）患者可出现甲状腺球蛋白抗体（TgAb）升高。本研究旨在探讨随访期间 TgAb 升高的预后意义。
回顾性分析一家三级中心的 79 例 DTC 患者，这些患者在全甲状腺/分期甲状腺切除术后 TgAb 升高。我们确定了 TgAb 水平稳定（7.6%）、升高（15%）和降低（77.2%）的患者，分别为组 1、组 2 和组 3。在随访期间，我们根据 TgAb 趋势（>50%升高、<50%升高、>50%降低、<50%降低、由阳性转为阴性/正常化、由阴性转为阳性和水平稳定）、性别、年龄、手术、自身免疫性疾病、组织学、RAI 摄取、远处转移和复发，对 TgAb 进行了亚组分析。
TgAb 水平升高的发生率为 33.2%，女性占优势。其他参数之间未发现关联。11.4%的患者有远处转移。组 2 的 TgAb 最高平均最大水平（1918.75 IU/mL），组 3 的 TgAb 最低平均最大水平（412.70 IU/mL）。3 组间的复发率差异有统计学意义：组 1 为 50%，组 2 为 75%，组 3 为 25%（P=0.002）。在 TgAb 由阳性转为阴性/正常化的亚组中，复发率降至 15%（P=0.0001）。在 TgAb 由阴性转为阳性或升高>50%的患者中，复发率分别为 100%（P=0.041）和 70%（P=0.012）。
随访期间 TgAb 水平升高的患者复发率较高，特别是 TgAb 由阴性转为阳性且升高>50%的患者。这些患者需要更密切的随访，TgAb 可能作为动态随访标志物。
