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

Abstract Background 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 Hürthl...

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Published inThe American journal of surgery Vol. 200; no. 1; pp. 41 - 46
Main Authors Suh, Insoo, M.D, Vriens, Menno R., M.D., Ph.D, Guerrero, Marlon A., M.D, Griffin, Ann, Ph.D, Shen, Wen T., M.D, Duh, Quan-Yang, M.D, Clark, Orlo H., M.D, Kebebew, Electron, M.D
Format Journal Article
LanguageEnglish
Published New York Elsevier Limited 01.07.2010
Subjects
Benign
Bioindicators
Biomarkers
Biopsy
Cancer
Cellular biology
Diagnostic systems
Immunoglobulins
Lesions
Malignancy
Metastasis
Neoplasms
Patients
Surgery
Thyroglobulin
Thyroid
Thyroid cancer
Tumors
Ultrasonic imaging
Hürthle-cell thyroid neoplasms
Thyroglobulin
Biological markers
Follicular thyroid neoplasms
Thyroid nodules
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Summary:Abstract Background 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. Methods 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. Results 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 μg/L had a positive predictive value of .75. Conclusions Tg has poor accuracy for predicting malignancy in follicular or Hürthle-cell thyroid neoplasms.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2009.08.030