Serum thyroglobulin in thyroid cancer.

Serum thyroglobulin (Tg) was measured in 274 patients with differentiated thyroid cancer; 266 had previous thyroidectomy, which had been followed by ablative iodine-131 in 183 cases. Neither the presence nor the titre of anti-Tg antibodies appeared to affect Tg assays. Serum Tg reflected the presence or absence of cancer in 83% of 164 patients not receiving thyroxine (T4). This concordance improved to 97.5% in 158 patients tested while receiving T4. 34 patients in remission were tested both on and off T4 therapy; in all these patients the Tg level when receiving T4 was less than 5 micrograms/l. In 19 of 21 patients with cancer T4 treatment did not suppress Tg. Serum Tg thus provides an excellent marker for the presence or absence of thyroid cancer in patients taking T4, even if anti-Tg antibodies are present. It is proposed that monitoring of patients by assay of serum Tg should supplant routine assessment by radioactive-iodine scans of the neck or whole body.