Eur J Endocrinol
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DOI: 10.1530/eje.1.01940
European Journal of Endocrinology, Vol 153, Issue 1, 49-55
Copyright © 2005 by European Society of Endocrinology
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CLINICAL STUDY

Development and clinical impact of thyroglobulin antibodies in patients with differentiated thyroid carcinoma during the first 3 years after thyroidectomy

R Görges, M Maniecki, W Jentzen, Sie n-Yi Sheu1, K Mann2, A Bockisch and O E Janssen2

Department of Nuclear Medicine, 1 Institute of Pathology and 2 Division of Endocrinology, Department of Medicine, University of Duisburg-Essen, Hufelandstrasse 55, 45 122 Essen, Germany

(Correspondence should be addressed to R Görges; Email: rainer.goerges{at}uni-essen.de)

Objective and design: Cross-sectional studies have reported an increased prevalence of circulating thyroglobulin autoantibodies (TgAbs) in patients with differentiated thyroid carcinoma (DTC). With the advent of more sensitive assays, a longitudinal study monitoring the development of TgAb levels after ablative therapy was warranted.

Methods: One hundred and twelve consecutive patients with follicular cell-derived thyroid cancer were followed for 3 years. All patients had been thyroidectomized and received, on average, two radioiodine therapies. Residual tissue was quantified scintigraphically by 131I 24-h uptake. TgAb and thyroglobulin (Tg) serum levels were determined with a sensitive direct radioligand assay and an IRMA respectively.

Results: The prevalence of TgAbs at the initial examination was 29% (median 130 U/ml). During follow-up, TgAb levels rose transiently in one-tenth of the patients, but the prevalence of demonstrable TgAbs decreased to <10% after 3 years. The median serum half-life of TgAbs in treated DTC patients was 10 weeks. At initial examination (when all patients still had residual thyroid tissue and 17 had metastases), rising TgAb levels were correlated with the inability to detect Tg in 4, 30 and 73% of the patients, when initial TgAbs were <6, 6–50 or >50 U/ml respectively. While the Tg recovery test was valid for all patients, an in vitro dilution assay with TgAb serum reduced Tg values by up to 32%.

Conclusions: The development and course of TgAbs in DTC patients cannot be predicted by initial or residual tumour volume, TgAb or Tg levels. The presence of TgAbs, even in low concentrations, may cause Tg underestimation despite valid recovery tests in DTC patients.




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A. C.M. Persoon, T. P. Links, J. Wilde, W. J. Sluiter, B. H.R. Wolffenbuttel, and J. M.W. van den Ouweland
Thyroglobulin (Tg) Recovery Testing with Quantitative Tg Antibody Measurement for Determining Interference in Serum Tg Assays in Differentiated Thyroid Carcinoma
Clin. Chem., June 1, 2006; 52(6): 1196 - 1199.
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