Affiliation:
1. Department of Endocrinology and Metabolism, Ankara University Faculty
of Medicine, Ankara, Turkey
2. Department of Nuclear Medicine, Ankara University Faculty of Medicine,
Ankara, Turkey
3. Department of Biostatistics, Ankara University Faculty of Medicine,
Ankara, Turkey
Abstract
AbstractWe aimed to evaluate the predictive ability of serum thyroglobulin (Tg) levels on
the localization of the metastatic lymph node compartments in locoregional
metastases of papillary thyroid cancer (PTC). This retrospective study included
143 patients who underwent neck dissections for a total of 172 for
persistent/recurrent locoregional PTC. They were grouped according to
the localization of lymph node metastasis (LNM): Central (C-LNM), Lateral
(L-LNM), both central and lateral LNM (C+L LNM). To confirm that the Tg
cutoff discriminated LNM localizations, the sample was categorized as suppressed
(<0.1 mU/l) or non-suppressed (>0.1 mU/l)
according to TSH and ROC analysis. Mixed-effects models were used to investigate
the effect of LNM localization on Tg levels and to eliminate the confounding
effects of TSH, tumor burden (defined as the number and the largest diameter of
LNM), and RAI. Mean Tg levels were 1.43 μg/l for C-LNM
(n=47), 3.7 μg/l for L-LNM (n=99), and
8.60 μg/l for C+L LNM (n=26).
Independent of TSH, tumor burden and RAI, the mean Tg levels of L-LNM and
C+L LNM groups were not significantly different, while that of C-LNM was
significantly lower than those of L-LNM and C+L LNM. To discriminate
C-LNM from L-LNM and C+L LNM in patients with TSH>0.1
mU/l, the optimal cutoff for Tg was 1.05 μg/l
(sensitivity=74.7%, specificity=70.4%,
PPV=87.7%). L-LNM increases serum Tg levels more than C-LNM in
persistent/recurrent locoregional nodal disease of PTC. Tg above
1.05 μg/l may indicate lateral LNM. Tg may be an
important marker for the localization of LNM in the neck.
Subject
Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,General Medicine,Endocrinology, Diabetes and Metabolism
Cited by
1 articles.
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