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Giovanella L, D’Aurizio F, Petranović Ovčariček P, Görges R. Diagnostic, Theranostic and Prognostic Value of Thyroglobulin in Thyroid Cancer. J Clin Med 2024; 13:2463. [PMID: 38730992 PMCID: PMC11084486 DOI: 10.3390/jcm13092463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/12/2024] [Accepted: 04/21/2024] [Indexed: 05/13/2024] Open
Abstract
Thyroglobulin (Tg) is an iodinated glycoprotein, which is normally stored in the follicular colloid of the thyroid, being a substrate for thyroid hormone production. Since it is produced by well-differentiated thyroid cells, it is considered a reliable tumor marker for patients with differentiated thyroid carcinoma (DTC) during their follow-up after total thyroidectomy and radioiodine ablation. It is used to monitor residual disease and to detect recurrent disease. After total thyroid ablation, unstimulated highly sensitive Tg measurements are sufficiently accurate to avoid exogenous or endogenous thyrotropin (TSH) stimulation and provide accurate diagnostic and prognostic information in the great majority of DTC patients. Adopting sophisticated statistical analysis, i.e., decision tree models, the use of Tg before radioiodine theranostic administration was demonstrated to be useful in refining conventional, pathology-based risk stratification and providing personalized adjuvant or therapeutic radioiodine administrations. The follow-up of DTC patients aims to promptly identify patients with residual or recurrent disease following primary treatment. Our review paper covers the diagnostic, theranostic and prognostic value of thyroglobulin in DTC patients.
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Affiliation(s)
- Luca Giovanella
- Department of Nuclear Medicine, Gruppo Ospedaliero Moncucco SA, Clinica Moncucco, 6900 Lugano, Switzerland
- Clinic for Nuclear Medicine, University Hospital and University of Zurich, 8006 Zurich, Switzerland
| | - Federica D’Aurizio
- Institute of Clinical Pathology, Department of Laboratory Medicine, University Hospital of Udine, 33100 Udine, Italy;
| | - Petra Petranović Ovčariček
- Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia;
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Rainer Görges
- Clinic for Nuclear Medicine, University Hospital of Essen, 45147 Essen, Germany;
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Sharma VK, Sonkhya N, Gupta S, Jat KS, Sehra R, Singhal P, Sharma MP, Agarwal S. Diagnostic Efficacy of Thyrotropin to Thyroglobulin Ratio in Correlation with Histopathology of Euthyroid Patient Having Solitary Thyroid Nodule. Indian J Otolaryngol Head Neck Surg 2022; 74:2281-2286. [PMID: 36452702 PMCID: PMC9702168 DOI: 10.1007/s12070-020-02120-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022] Open
Abstract
In patients with solitary thyroid nodules, the first course of action is to determine whether the nodule is benign or malignant. Many investigations are used to differentiate between benign and malignant nodules so as to avoid surgery in those who don't need it. Among these, FNAC and USG are commonly used in association with clinical features but there are drawbacks of each technique. The present study was undertaken to assess the diagnostic effectivity of thyrotropin (also known as TSH) to thyroglobulin ratio in correlation with histopathology in euthyroid patients having solitary thyroid nodule. This is a prospective study carried out on 48 euthyroid cases of solitary thyroid nodule. All patients subjected to FNAC, USG, thyrotropin and thyroglobulin assay. Then, they underwent surgery and histopathological examination (HPE) of the specimens done. Finally, the histopathology reports were correlated with the thyrotropin to thyroglobulin ratio in order to evaluate their sensitivity and specificity by statistical methods. The sensitivity and specificity of thyrotropin to thyroglobulin ratio was 100% and 100% respectively. All malignant lesions according to thyrotropin to thyroglobulin ratio were confirmed by histopathology indicating its excellence. Therefore, TSH to thyroglobulin ratio helps in planning the correct management and avoids second surgery. It was found that serum TSH:Tg is a safe, reliable and effective diagnostic modality with a high sensitivity and specificity and is the single best investigation for preoperative evaluation of solitary thyroid nodule to differentiate between benign and malignant nodules.
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Affiliation(s)
- Vijay Kumar Sharma
- Department of Otorhinolaryngology, SMS Medical College, C168E, Street No. 2, Khadi Colony, Bajaj Nagar, Jaipur, Rajasthan 302015 India
| | - Nishi Sonkhya
- Department of Otorhinolaryngology, SMS Medical College, C168E, Street No. 2, Khadi Colony, Bajaj Nagar, Jaipur, Rajasthan 302015 India
| | - Shubhangi Gupta
- Department of Otorhinolaryngology, SMS Medical College, C168E, Street No. 2, Khadi Colony, Bajaj Nagar, Jaipur, Rajasthan 302015 India
| | - Kailash Singh Jat
- Department of Otorhinolaryngology, SMS Medical College, C168E, Street No. 2, Khadi Colony, Bajaj Nagar, Jaipur, Rajasthan 302015 India
| | - Ritu Sehra
- Department of Otorhinolaryngology, SMS Medical College, C168E, Street No. 2, Khadi Colony, Bajaj Nagar, Jaipur, Rajasthan 302015 India
| | - Pawan Singhal
- Department of Otorhinolaryngology, SMS Medical College, C168E, Street No. 2, Khadi Colony, Bajaj Nagar, Jaipur, Rajasthan 302015 India
| | - Man Prakash Sharma
- Department of Otorhinolaryngology, SMS Medical College, C168E, Street No. 2, Khadi Colony, Bajaj Nagar, Jaipur, Rajasthan 302015 India
| | - Sunita Agarwal
- Department of Otorhinolaryngology, SMS Medical College, C168E, Street No. 2, Khadi Colony, Bajaj Nagar, Jaipur, Rajasthan 302015 India
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Li S, Ren C, Gong Y, Ye F, Tang Y, Xu J, Guo C, Huang J. The Role of Thyroglobulin in Preoperative and Postoperative Evaluation of Patients With Differentiated Thyroid Cancer. Front Endocrinol (Lausanne) 2022; 13:872527. [PMID: 35721746 PMCID: PMC9200986 DOI: 10.3389/fendo.2022.872527] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/29/2022] [Indexed: 12/02/2022] Open
Abstract
Thyroglobulin (Tg) is secreted by thyroid follicular cells and stored in the thyroid follicular lumen as a component of thyroid hormone. It is known that both benign and well-differentiated malignant thyroid tissue can secrete Tg. In recent years, growing lines of evidence have shown that Tg plays an important role in the diagnosis and metastasis of preoperative differentiated thyroid carcinoma (DTC). The levels of Tg, whether in the serum or in a fine-needle aspiration washout fluid, are usually viewed as an excellent indicator in the monitoring of postoperative DTC, including the guidance and evaluation of radioactive iodine ablation. Nevertheless, some factors limit the application of Tg, such as the method used to measure Tg and the presence of Tg antibodies. This review aimed to summarize the role of Tg in the preoperative and postoperative evaluation of patients with DTC, and the factors influencing Tg. This review could provide a reference for a more accurate application of Tg in patients with DTC.
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Affiliation(s)
| | - Chutong Ren
- *Correspondence: Jiangsheng Huang, ; Chutong Ren,
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Karvounis E, Kappas I, Angelousi A, Makris GM, Siamatras TD, Kassi E. The diagnostic and predictive accuracy of thyroglobulin to TSH ratio and TSH to thyroglobulin ratio in detecting differentiated thyroid carcinoma in normothyroid patients with thyroid nodules: A retrospective cohort study and systematic review of the literature. Oncol Rev 2021; 14:439. [PMID: 33505608 PMCID: PMC7814274 DOI: 10.4081/oncol.2020.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/09/2020] [Indexed: 11/23/2022] Open
Abstract
The purpose of the present study is to examine the diagnostic and predictive accuracy of the thyroglobulin (Tg) to thyroid stimulating hormone (TSH) and TSH/Tg ratios in normothyroid patients with differentiated thyroid cancer (DTC). We conducted a retrospective cohort study evaluating the diagnostic accuracy of the serum Tg/TSH and TSH/Tg ratios in normothyroid patients with thyroid nodules. We also systematically searched the international literature using the Medline, Cochrane's CENTRAL, Scopus, Clinicaltrials.gov, EMBASE, and Google Scholar databases for evidence concerning the diagnostic and predictive accuracy of these ratios. Overall, 374 patients were identified in our cohort study of whom 240 were treated for benign disease and 134 were treated for DTC. Significant differences were noted in the Tg/TSH and TSH/Tg values among cases with malignant and benign disease (P=0.020). However, the diagnostic ROC curve did not confirm these results (Tg/TSH=0.572 and TSH/Tg=0.428). After searching the international literature, we identified 8 studies. The majority of the included data reported significant differences among patients with benign/malignant disease and those with successful iodine therapy compared to those with disease relapse. However, the clinical relevance was clearer among studies that investigated the usefulness of these ratios in predicting recurrent disease. The findings of our study support that the Tg/TSH ratio increases in patients with DTC and can, thus, become useful in the future as a predictive marker of ablative 131I therapy success. However, given the significant variability of Tg its diagnostic accuracy remains to date minimal; thus, the actual cut-off value that can be used to discriminate cancer cases from benign disease has not been determined yet.
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Affiliation(s)
- Evangelos Karvounis
- Department of Endocrine Surgery Center of Excellence, Euroclinic Hospital, Athens
| | - Ioannis Kappas
- Department of Endocrine Surgery Center of Excellence, Euroclinic Hospital, Athens
| | - Anna Angelousi
- Department of Internal Medicine, Laiko hospital, National and Kapodistrian University of Athens
| | | | - Thomas D Siamatras
- Department of Endocrine Surgery Center of Excellence, Euroclinic Hospital, Athens
| | - Eva Kassi
- Department of Internal Medicine, Laiko hospital, National and Kapodistrian University of Athens.,Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Li Z, Yang K, Zhang L, Wei C, Yang P, Xu W. Classification of Thyroid Nodules with Stacked Denoising Sparse Autoencoder. Int J Endocrinol 2020; 2020:9015713. [PMID: 33488708 PMCID: PMC7787836 DOI: 10.1155/2020/9015713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Several commercial tests have been used for the classification of indeterminate thyroid nodules in cytology. However, the geographic inconvenience and high cost confine their widespread use. This study aims to develop a classifier for conveniently clinical utility. METHODS Gene expression data of thyroid nodule tissues were collected from three public databases. Immune-related genes were used to construct the classifier with stacked denoising sparse autoencoder. RESULTS The classifier performed well in discriminating malignant and benign thyroid nodules, with an area under the curve of 0.785 [0.638-0.931], accuracy of 92.9% [92.7-93.0%], sensitivity of 98.6% [95.9-101.3%], specificity of 58.3% [30.4-86.2%], positive likelihood ratio of 2.367 [1.211-4.625], and negative likelihood ratio of 0.024 [0.003-0.177]. In the cancer prevalence range of 20-40% for indeterminate thyroid nodules in cytology, the range of negative predictive value of this classifier was 37-61%, and the range of positive predictive value was 98-99%. CONCLUSION The classifier developed in this study has the superb discriminative ability for thyroid nodules. However, it needs validation in cytologically indeterminate thyroid nodules before clinical use.
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Affiliation(s)
- Zexin Li
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou 515041, China
| | - Kaiji Yang
- Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou 515041, China
| | - Lili Zhang
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou 515041, China
| | - Chiju Wei
- Multidisciplinary Research Center, Shantou University, No. 243, Daxue Road, Shantou 515063, China
| | - Peixuan Yang
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou 515041, China
| | - Wencan Xu
- Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou 515041, China
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Pytynia KB. Why Participate in Peer Review as a Journal Manuscript Reviewer: What's in It for You? Otolaryngol Head Neck Surg 2016; 156:976-977. [PMID: 27677597 DOI: 10.1177/0194599816669661] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The peer review process for scientific journals relies on the efforts of volunteer reviewers. Reviewers are selected due to their expertise in their fields. With so many demands on professional time, the benefits of participating in peer review may not be obvious. However, reviewers benefit by exposure to the latest developments in their fields, facilitating their keeping up-to-date with the latest publications. Tenure committees look favorably on participation in peer review, and invitations to review underscore that the reviewer is a respected subject matter expert. Contacts made during the peer review process can lead to long-lasting collaboration. Continuing medical education credit can be obtained through various mechanisms. Overall, participating in peer review is an important part of career development and should be viewed as a critical component of advancement.
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Affiliation(s)
- Kristen B Pytynia
- 1 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Zheng J, Li C, Lu W, Wang C, Ai Z. Quantitative assessment of preoperative serum thyrotropin level and thyroid cancer. Oncotarget 2016; 7:34918-29. [PMID: 27166998 PMCID: PMC5085199 DOI: 10.18632/oncotarget.9201] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/16/2016] [Indexed: 01/11/2023] Open
Abstract
Thyroid stimulating hormone (TSH) is the major growth factor for thyrocytes, but the pathogenic role of serum TSH in thyroid cancer (TC) is unknown. The association between TSH level and the development of thyroid cancer has been widely evaluated recently. However, the results remain conflicting. To develop an understanding of the relationship between TSH exposure and thyroid cancer, a meta-analysis of 56 studies involving 20227 thyroid cancer cases and 50003 controls with benign thyroid nodule was performed. Overall, significantly increased TSH level was observed in thyroid cancer patients compared with controls (RoM: 1.44, 95% CI: 1.32-1.56, P < 10-5). The pooled analyses also revealed that higher serum TSH level were significantly associated with the size of TC nodule and malignancy as well as lymph node metastasis. Furthermore, significantly increased THS levels were observed preferentially for papillary thyroid cancer when stratified by histological type of tumors. However, the diagnostic value of TSH level for TC might be limited. These results suggest that higher serum TSH concentration is associated with an increased risk of thyroid cancer.
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Affiliation(s)
- Jiaojiao Zheng
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Chen Li
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Weihui Lu
- Department of General Surgery, Zhongshan Hospital (Qingpu Branch), Fudan University, Shanghai 201700, P.R. China
| | - Cong Wang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Zhilong Ai
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
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