Clinical significance of tracing thyroglobulin in predicting metastasis of post-operative patients with differentiated thyroid carcinoma before its first pre-ablation with 131I / 中华内分泌代谢杂志

ABSTRACT

Objective To investigate the value of tracing thyroglobulin(Tg)in predicting metastasis of post-operative patients with differentiated thyroid carcinoma(DTC)before its first pre-ablation with 131I. Methods 106 cases with DTC, undergoing total thyroidectomy and lymphadenectomy, were assigned to 2 groups as M0 group (without metastasis)and M1 group(with metastasis). Clinical data including pre-ablation stimulated thyroglobulin (sTg)and pre-operative Tg were determined. sTg, pre-operative Tg, Tg variation(△Tg), and Tg variation rate (△Tg/pre-operative Tg)between 2 groups were compared. The ROC curve and the diagnostic critical point(DCP) were analyzed. Results sTg, Pre-operative Tg, Tg variation, and Tg variation rate were significantly higher than those of M0(all P<0.01). The corresponding areas under the ROC curve(AUC)to differentiate the two groups were 0.913,0.702,0.773,and 0.943,respectively. The best diagnostic value points(DCP)were 40.60 ng/ml and-72.5%. The sensitivity and specificity were 70. 21%, 100. 00%, and 89. 36%, 88. 13%, respectively. Conclusion The pre-ablation sTg seems to be a useful diagnostic marker for predicting metastasis before the first 131I ablation. The sTg value can be effectively corrected by the Tg variation rate,and the sensitivity and accuracy of sTg for metastasis in DTC patients can be improved,finally providing evidence for pre-ablative assessment as well as strategies of 131I therapy.