Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave., C-313 Mail Stop, Aurora, CO, 80045, United States.
Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, 12801 E. 17th Ave., 7103, Research 1 South, Aurora, CO, 80045, United States; Department of Biomedical Informatics, University of Colorado School of Medicine, 1890 N. Revere Court, Mailstop F600, Aurora, CO, 80045, United States.
Am J Surg. 2024 Dec;238:115818. doi: 10.1016/j.amjsurg.2024.115818. Epub 2024 Jul 3.
Thyroid cancer has an overall favorable prognosis, but no pre-operative biochemical marker has been shown to distinguish between low and high-risk disease or predict response to therapy.
We retrospectively reviewed 162 patients that underwent thyroid surgery for thyroid cancer between 2006 and 2022 in whom a pre-operative thyroglobulin level (Tg) was measured. We subdivided patients into low, intermediate and high-risk thyroid cancer and based on their response to therapy per ATA guidelines.
We showed that as pre-operative Tg level increased, patients were more likely to have high-risk disease (p < 0.01). We found a linear association between the primary tumor size and high-risk histology with pre-operative Tg (p < 0.01). Pre-operative Tg level was significantly associated with response to therapy following initial surgical management. Specifically, as pre-operative Tg increases, patients were less likely to achieve an excellent response (p < 0.01).
Our retrospective analysis demonstrated that pre-operative Tg is significantly associated with ATA structural risk of recurrence and response to therapy and may have the potential to guide initial therapy and follow-up management.
甲状腺癌总体预后良好，但尚无术前生化标志物可区分低危和高危疾病，或预测对治疗的反应。
我们回顾性分析了 2006 年至 2022 年间因甲状腺癌接受甲状腺手术的 162 例患者，这些患者在术前测量了甲状腺球蛋白（Tg）水平。我们将患者分为低危、中危和高危甲状腺癌，并根据 ATA 指南中对治疗的反应进行了分类。
我们发现，随着术前 Tg 水平的升高，患者更有可能患有高危疾病（p < 0.01）。我们发现术前 Tg 与原发肿瘤大小和高危组织学之间存在线性关联（p < 0.01）。术前 Tg 水平与初始手术治疗后的治疗反应显著相关。具体而言，随着术前 Tg 的升高，患者不太可能获得优异的反应（p < 0.01）。
我们的回顾性分析表明，术前 Tg 与 ATA 复发结构风险和对治疗的反应显著相关，可能有潜力指导初始治疗和随访管理。
