Clinicopathological relevance of antithyroglobulin antibodies in low‐risk papillary thyroid cancer

• Published in: Clinical otolaryngology Vol. 42; no. 6; pp. 1130 - 1134
• Main Authors: Morand, G.B., Silva, S.D., Mlynarek, A.M., Black, M.J., Payne, R.J., Hier, M.P.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2017
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies; Autoantibodies - blood; biomarkers; Cancer; Carcinoma, Papillary - blood; Carcinoma, Papillary - pathology; Carcinoma, Papillary - surgery; Female; Follow-Up Studies; head and neck endocrine pathology; head and neck endocrine surgery; Health risks; Humans; Iodine; Male; Medical personnel; Medical records; Middle Aged; Neoplasm Recurrence, Local - blood; Neoplasm Recurrence, Local - etiology; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Papillary thyroid cancer; Patients; Predictive Value of Tests; Retrospective Studies; Risk Factors; Risk management; Surgery; surgical outcome; Thyroid; Thyroid cancer; Thyroid Cancer, Papillary; Thyroid Neoplasms - blood; Thyroid Neoplasms - pathology; Thyroid Neoplasms - surgery; Thyroidectomy; Thyroiditis; Time Factors; Treatment Outcome; Young Adult; head and neck endocrine pathology; thyroid cancer; surgical outcome; biomarkers; head and neck endocrine surgery
• ISSN: 1749-4478; 1749-4486
• DOI: 10.1111/coa.12835

Objective The extent of initial surgical management in papillary thyroid cancer (PTC) is controversial. We examined whether the presence of perioperative antithyroglobulin antibodies (TGA) could predict long‐term recurrence and occurrence of adverse features among a homogenous group of patients with PTC. Methods The clinical features of patients with PTC treated at a single institution (Jewish General Hospital, McGill University, Montreal, Canada) were obtained from the medical records, and all clinicopathologic information was reviewed. Only low‐risk PTC without clinical evidence of nodal disease before surgery and treated with 30 mCi of radioactive iodine was included in the study. Results The chart review retrieved 361 patients with a median follow‐up of 85.0 months (Q25‐Q75 73‐98). Forty‐two (11.6%) patients had presence of perioperative TGA. Perioperative TGAs were associated with present extrathyroidal extension (P=.005), unsuspected nodal disease (P=.001) and autoimmune thyroiditis (P<.0001). Overall, 17 (4.7%) patients experienced locoregional recurrence. Perioperative TGAs were a significant predictor of recurrence in univariable (P=.021) but not in multivariable analysis (P=.13). Conclusion Presence of perioperative TGAs is associated with aggressive histological features and the presence of thyroiditis. Detection of TGA perioperatively may encourage surgeons to consider more extensive initial surgery.