Serum thyroglobulin is a poor diagnostic biomarker of malignancy in follicular and Hurthle-cell neoplasms of the thyroid

American Journal of Surgery
Insoo SuhElectron Kebebew

Abstract

Serum thyroglobulin (Tg) is the most accurate biomarker for thyroid cancer recurrence. However, some clinicians measure preoperative Tg as a diagnostic cancer marker despite lack of supporting evidence. We examined whether Tg accurately predicts malignancy in follicular or Hürthle-cell neoplasms. We reviewed 366 patients who underwent thyroidectomies for follicular/Hürthle-cell neoplasms. We compared Tg in malignant versus benign tumors by univariate and receiver-operator characteristic analyses. We also examined several Tg-derived indices that normalized Tg to known confounding factors including nodule size, thyroid function, and type of Tg assay. Thirty-nine patients met inclusion criteria for analysis. There were no differences between malignant (n = 16) and benign (n = 23) lesions in Tg or any of the normalized indexes. Receiver-operator characteristic analysis revealed an area under the curve of .59. Lesions with Tg levels greater than 500 mug/L had a positive predictive value of .75. Tg has poor accuracy for predicting malignancy in follicular or Hürthle-cell thyroid neoplasms.

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Citations

Mar 5, 2013·Langenbeck's Archives of Surgery·Henning DralleUNKNOWN German Societies of General and Visceral Surgery; Endocrinology; Nuclear Medicine; Pathology; Radiooncology; Oncological Hem
May 18, 2016·The Indian Journal of Surgery·Michael Shawky, Mahmoud Sakr
Mar 13, 2014·Expert Review of Proteomics·Haitham A BadrChen-Zhong Li
Apr 18, 2015·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Lina WangQuan Zhang
May 4, 2016·Current Opinion in Pediatrics·Andrew J Bauer, Gary L Francis
Dec 14, 2018·JAMA Oncology·Allen S HoZachary S Zumsteg
Jul 14, 2017·Clinical Diabetes and Endocrinology·Shrikant Tamhane, Hossein Gharib
Jan 15, 2014·The Journal of Surgical Research·Sarah C OltmannRebecca S Sippel

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