Predictive Value of Serum Thyroglobulin After Surgery for Thyroid Carcinoma

作者：Francis T. Hall, Nigel J P Beasley, Spiro J. Eski, Ian Witterick, Paul G. Walfish, Jeremy L. Freeman · 发表于：The Laryngoscope · 年份：2003 · DOI：10.1097/00005537-200301000-00014 · 被引用次数：61 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid Disorders and Treatments、Thyroid and Parathyroid Surgery

OBJECTIVE: To determine the relationship between stimulated serum thyroglobulin levels (taken 3 months after total thyroidectomy) and tumor stage and recurrence in patients with well-differentiated thyroid carcinoma. STUDY DESIGN: Retrospective chart review in a tertiary care institution. METHODS: Two hundred thirteen consecutive patients with well differentiated thyroid carcinoma treated between 1983 and 1998 were identified. Data were collected on clinicopathological variables, stimulated serum thyroglobulin levels obtained 3 months after total thyroidectomy prior to 131I therapy and recurrence. RESULTS: A high postoperative thyroglobulin level was significantly associated with advanced-stage disease at presentation (P =.005, Kruskall-Wallis) but not with any of the other clinicopathological variables. Patients with a thyroglobulin level greater than 20 pmol/L had a significantly increased risk of disease recurrence on univariate analysis (n = 213 [P =.0001, log rank test]), and in the Cox proportional-hazards model, both advanced tumor stage (P =.001, relative hazard, 3.4 [95% confidence interval [CI]: 2.4-4.9]) and a thyroglobulin level greater than 20 pmol/L (P =.001, relative hazard, 5.1 [95% CI: 2.0-13.1]) were significant predictors of recurrence. No other variables significantly altered the hazards model. CONCLUSIONS: Advanced tumor stage at diagnosis and a stimulated thyroglobulin level greater than 20 pmol/L taken 3 months after total thyroidectomy were independent...