ABSTRACT
We have compared two "markers" in the follow up of post treatment (surgery and therapeutical use of I-131) differentiated thyroid carcinoma. In 153 patients, thyroglobulin (Tg) serum levels were measured after withdrawal of I-thyroxine therapy, before performing a whole-body scan (WBS) with iodine-131; in 55 of these patients, Tg was measured again after at least 45 days of I-thyroxine treatment. The patients were followed between 3 and 10 years, and there were 2713 matched studies. Our results indicate for both parameters, false positive and negative values; sensitivity (SE) for WBS was 89% and specificity (SP) 83%; Tg presents a SE of 86% and SP of 83%. Matching both parameters, SE was 95% and SP 98%. The causes of false results are discussed. Tg determinations under I-thyroxine treatment do not permit the establishment of absence of illness; 37.7% of patients with demonstrated metastases or relapse showed negative Tg values that reached pathological values after suspension of I-thyroxine treatment; another 41.4% with elevated Tg values under therapy reached these values after suspension of I-thyroxine. Both markers, when utilized at the same time, offer the best possibilities in the follow-up of differentiated thyroid carcinoma, when determinations are carried out after suspension of hormonal treatment.
Subject(s)
Adenocarcinoma/blood , Adenocarcinoma/diagnostic imaging , Biomarkers, Tumor , Carcinoma, Papillary/blood , Carcinoma, Papillary/diagnostic imaging , Thyroglobulin/blood , Thyroid Neoplasms/blood , Thyroid Neoplasms/diagnostic imaging , Adolescent , Adult , Aged , Biomarkers, Tumor/blood , Female , Follow-Up Studies , Humans , Iodine Radioisotopes , Male , Middle Aged , Neoplasm Metastasis/diagnosis , Neoplasm Recurrence, Local/diagnosis , Radionuclide Imaging , Sensitivity and Specificity , Thyroxine/administration & dosageABSTRACT
Hemos comparado el valor de los indicadores en el seguimiento del carcinoma tiroideo diferenciado (CaDT): tiroglobulina sérica (Tg) y rastreo corporal total con I-131 (RCT), que fueron realizados entre 3 y 10 años después del tratamiento quirúrgico más dosis terapéutica de I-131. Se realizaron en 153 pacientes 2713 estudios apareados, que se efectuaron con suspensión de la opoterapia por más de 30 días. En 55 pac. se realizaron determinaciones de Tg bajo opoterapia y en 18 en las mismas condiciones, determinaciones seriadas durante 6 meses. Los resultados indican que ambos parámetros pueden presentar falsos positivos y negativos, discutiéndose las razones de los mismos. La sensibilidad (S) para RCT fue de 89% y la especificidad (E) de 83% y para Tg S de 86% y E de 83%; si se consideran ambos parámetros en forma conjunta, S 95% y E 98%. La determinación de Tg bajo opoterapia no permite estabelecer la existencia de metástasis o recidivas con iguales posibilidades que luego de suspensión de la misma. El 37,7% de los casos con enfermedad demostrable, presentaron valores negativos de Tg bajo opoterapia que se elevaron a valores patológicos ...
Subject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Adenocarcinoma/diagnosis , Carcinoma, Papillary/diagnosis , Thyroid Neoplasms/diagnosis , Adenocarcinoma , Carcinoma, Papillary , Follow-Up Studies , Neoplasm Metastasis/diagnosis , Neoplasm Recurrence, Local/diagnosis , Iodine Radioisotopes , Sensitivity and Specificity , Thyroid Neoplasms , Thyroxine/administration & dosageABSTRACT
Hemos comparado el valor de los indicadores en el seguimiento del carcinoma tiroideo diferenciado (CaDT): tiroglobulina sérica (Tg) y rastreo corporal total con I-131 (RCT), que fueron realizados entre 3 y 10 años después del tratamiento quirúrgico más dosis terapéutica de I-131. Se realizaron en 153 pacientes 2713 estudios apareados, que se efectuaron con suspensión de la opoterapia por más de 30 días. En 55 pac. se realizaron determinaciones de Tg bajo opoterapia y en 18 en las mismas condiciones, determinaciones seriadas durante 6 meses. Los resultados indican que ambos parámetros pueden presentar falsos positivos y negativos, discutiéndose las razones de los mismos. La sensibilidad (S) para RCT fue de 89% y la especificidad (E) de 83% y para Tg S de 86% y E de 83%; si se consideran ambos parámetros en forma conjunta, S 95% y E 98%. La determinación de Tg bajo opoterapia no permite estabelecer la existencia de metástasis o recidivas con iguales posibilidades que luego de suspensión de la misma. El 37,7% de los casos con enfermedad demostrable, presentaron valores negativos de Tg bajo opoterapia que se elevaron a valores patológicos ... (AU)
Subject(s)
Adolescent , Adult , Middle Aged , Aged , Humans , Male , Female , Comparative Study , Thyroid Neoplasms/diagnosis , Carcinoma, Papillary/diagnosis , Adenocarcinoma/diagnosis , Thyroid Neoplasms/diagnostic imaging , Carcinoma, Papillary/diagnostic imaging , Adenocarcinoma/diagnostic imaging , Thyroxine/administration & dosage , Iodine Radioisotopes/diagnosis , Neoplasm Metastasis/diagnosis , Neoplasm Recurrence, Local/diagnosis , Sensitivity and Specificity , Follow-Up StudiesABSTRACT
We have compared two [quot ]markers[quot ] in the follow up of post treatment (surgery and therapeutical use of I-131) differentiated thyroid carcinoma. In 153 patients, thyroglobulin (Tg) serum levels were measured after withdrawal of I-thyroxine therapy, before performing a whole-body scan (WBS) with iodine-131; in 55 of these patients, Tg was measured again after at least 45 days of I-thyroxine treatment. The patients were followed between 3 and 10 years, and there were 2713 matched studies. Our results indicate for both parameters, false positive and negative values; sensitivity (SE) for WBS was 89
and specificity (SP) 83
; Tg presents a SE of 86
and SP of 83
. Matching both parameters, SE was 95
and SP 98
. The causes of false results are discussed. Tg determinations under I-thyroxine treatment do not permit the establishment of absence of illness; 37.7
of patients with demonstrated metastases or relapse showed negative Tg values that reached pathological values after suspension of I-thyroxine treatment; another 41.4
with elevated Tg values under therapy reached these values after suspension of I-thyroxine. Both markers, when utilized at the same time, offer the best possibilities in the follow-up of differentiated thyroid carcinoma, when determinations are carried out after suspension of hormonal treatment.
