PREOPERATIVE Ac ANTI-THYROGLOBULIN COULD BE A POTENTIAL RISK FACTOR FOR DIFFERENTATED THYROID CANCER
Abstract
Hashimoto thyroiditis (HT) is an autoimmune disease and the most common cause of hypothyroidism. It is characterized by the presence of thyroid antibodies (Tg Ab and TPO Ab ).
Material and Methods: In a retrospective study we analyzed the date of 201 patients, who underwent total thyroidectomy during a period from January 2013 until February 2016. Tg Abs was measured in all patients before surgery.
Results: Females were 84.5%; males 15.4%; 57.7% with benign pathology and 42.2% with malignant pathology. Papillary thyroid cancer (PTC) accounted for the vast majority of the differentiated thyroid cancer (DTC) diagnoses (95.1%, n=79). There was no difference in the sex ratio between patients with benign tumors or DTC (p=0.66). Patients with DTC were relatively younger (43.2 ± 14.9 versus 48.4 ± 13.6 yr; p=0.760) and had higher preoperative median TSH levels (2.42 mIU/L versus 1.38 mIU/L; p<0.028) than those with benign nodule. Solitary nodules were more common in patients with DTC (40.4%) compared to patients with benign nodules (19.4%; p<0.001). Patients with TgAb concentration more than 115 IU/mL were more common in DTC group than in benign nodule group (28.2% versus 13%, p<0.007), suggesting that elevated Tg Ab may associate DTC. The prevalence of DTC was significantly associated with TgAb ≥ 115 IU/mL (OR=2.8), compared with TgAb < 115 IU/mL group.
Conclusions. Elevated serum TgAb level was associated with an increased risk of TC in patients with TN. We can conclude that high serumTgAb levels may serve as a predictive marker for DTC.
Downloads
References
histopathological diagnosis of thyroid cancers. Turk J Med Sci 2011; 41 (3):487-493.
2. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid
Cancer. Haugen, Alexander, et al., Thyroid. Jan 2016, 26(1): 1-133.
3. Antonaci A, Consorti F, Mardente S, Giovannone G. Clinical and biological relationship between chronic lymphocytic thyroiditis and papillary thyroid carcinoma. Oncology Research. 17 2009, 495–503.
4. Ahmed R, Al-Shaikh S, Akhtar M. Hashimoto’s thyroiditis: a century later. Advances in Anatomic Pathology, 19, 2012; 181–186.
5. Pacini F, Mariotti S, Formica N, Elisei R. Thyroid autoantibodies in thyroid cancer: incidence and relationship with tumor outcome. Acta Endocrinology 1988; 119:373–380.
6. Chung JK, Park YJ, Kim TY, So Y, Kim SK, Park DJ, et al. Clinical significance of elevated level of serum antithyroglobulin antibody in patients with differentiated thyroid cancer after thyroid ablation. Clinical Endocrinology. 2002; 57:215–21.
7. Gorges R, Maniecki M, Jentzen W, Sheu SN, Mann K, Bockisch A, et al. Development and clinical impact of thyroglobulin antibodies in patients with differentiated thyroid carcinoma during the first 3 years after thyroidectomy. European Journal of Endocrinology, 2005; 153:49–55.
8. Kumar A, Shah DH, Shrihari U, Dandekar SR, Vijayan U, Sharma SM. Significance of antithyroglobulin autoantibodies in differentiated thyroid carcinoma. Thyroid 1994; 4:199–202.
9. Latrofa F, Ricci D, Montanelli L, Rocchi R, Piaggi P, Sisti E, et al. Thyroglobulin autoantibodies in patients with papillary thyroid carcinoma: comparison of
different assays and evaluation of causes of discrepancies. Journal of Clinical Endocrinology and Metabolism 2012;97:3974–82.
10. Grebe SK. Thyroglobulin autoantibodies, thyroid nodules, and new insights into some old questions. Thyroid 2010; 20: 841–2.
11. Jankovic B, Le KT, Hershman JM. Hashimoto’s thyroiditis and papillary thyroid carcinoma: is there a correlation? Journal of Clinical Endocrinology and Metabolism 2013; 98:474–82.
12. Kim ES, Lim DJ, Baek KH, Lee JM, Kim MK, Kwon HS, et al. Thyroglobulin antibody is associated with increased cancer risk in thyroid nodules. Thyroid 2010; 20:885–91.
13. Kebebew E, Treseler PA, Ituarte PH, Clark OH. Coexisting chronic lymphocytic thyroiditis and papillary thyroid cancer revisited. World Journal of Surgery 2001; 25:632–7.
14. Larbre H, Schvartz C, Schneider N, Delcourt AC, Maes B, Pochart JM & Vaudrey C. Positive antithyroglobulin antibodies in patients with differentiated thyroid carcinoma. What signifi- cance]. Annales d’Endocrinologie. 2000;61:422–427.
15. Verburg FA, Luster M, Cupini C, Chiovato L, Duntas L, Elisei R et al.Thyroid. 2013 Oct; 23(10):1211-25.
16. Azizi G, Keller JM, Lewis M, Piper K, Puett D, Rivenbark KM et al. Association of Hashimoto’s thyroiditis with thyroid cancer. Endocr Relat Cancer. 2014;21(6):845-852
17. Rago T, Fiore E, Scutari M, Santini F, Di Coscio G, Romani R,et al. Male sex, single nodularity, and young age are associated with the risk of finding a papillary thyroid cancer on fine-needle aspiration cytology in a large series of patients with nodular thyroid disease. Eur J Endocrinol. 2010 Apr; 162(4):763-770.
18. Raparia K, Min SK, Mody DR, Anton R, Amrikachi M. Clinical outcomes for “suspicious” category in thyroid fineneedle aspiration biopsy: patient’s sex and nodule size are possible predictors of malignancy. Arch Pathol Lab Med. 2009 May; 133(5):787-790.
19. Lubitz CC, Faquin WC, Yang J, Mekel M, Gaz RD, Parangi S et al. Clinical and cytological features predictive of malignancy in thyroid follicular neoplasms. Thyroid. 2010 Jan; 20(1):25-31.
20. Boelaert K, Horacek J, Holder RL, Watkinson JC, Sheppard MC, Franklyn JA. Serum thyrotropin concentration as a novel predictor of malignancy in thyroid
nodules investigated by fine-needle aspiration. Journal of Clinical Endocrinology and Metabolism. 2006;91: 4295–4301.
