Clincial Investigations
Predictive value of postoperative initial stimulated thyroglobulin level on distant metastasis of differentiated thyroid carcinoma
Ying Ding, Wenliang Li, Qiang Li, Deyu Li, Fuqiang Zhang, Xianmin Ding, Lijun Wang, Hongbiao Chen, Jianmin Jia, Hui Yang
Published 2019-07-25
Cite as Int J Radiat Med Nucl Med, 2019, 43(4): 308-313. DOI: 10.3760/cma.j.issn.1673-4114.2019.04.003
Abstract
ObjectiveTo investigate the predictive value of postoperative initial stimulated thyroglobulin(ps-Tg) level on the distant metastasis of differentiated thyroid carcinoma(DTC).
MethodsA total of 113 patients who suffered from DTC and underwent first radioactive iodine(RAI) therapy from August 2016 to August 2017 were identified. Of these patients, 32 were males and 81 were females. Their ages ranged from 15 years to 68 years (44.85±12.01 years). The patients were classified into a non-distant metastasis(M0) group and a distant metastasis(M1) group. The biochemical parameters of thyroid function and thyroid antibodies were evaluated after 4 weeks of levothyroxine withdrawal. After RAI therapy, whole body imaging and local SPECT/CT were performed. The basic data of the two groups were compared via a chi-square test, Student's t test, and a Mann-Whitney ranksum test. ps-Tg values between M0 and M1 were also compared via the Mann-Whitney rank-sum test. An receiver operating characteristic(ROC) curve was drawn and analyzed to evaluate the predictive value of ps-Tg, and a diagnostic critical point(DCP) was obtained.
ResultsDifferences in pathological type, cervical lymph node metastasis, and RAI dose were observed between M0(85 cases) and M1(28 cases) (χ2=12.588, 12.588, 12.581; P=0.003, 0.003, 0.002). No significant differences were found in gender, age, tumor stage, and time from surgery to the first measurement of Tg, TSH, and TgAb between the two groups. The mean values M(P25~P75) of ps-Tg levels in the two groups were 1.95(0.70- 6.98) and 95.05 (6.98- 278.47) ng/mL. A significant difference was present between the two groups(U=417.5, P=0.000). The area under the ROC curve of ps-Tg levels was 0.825(95%CI: 0.713- 0.936), with a sensitivity of 71.4%, a specificity of 91.8%, and an accuracy of 86.7%. The cutoff value of DCP was 28.80 ng/mL.
ConclusionThe initial ps-Tg level is a meaningful indicator for predicting the distant metastases of DTC.
Key words:
Differentiated thyroid carcinoma; Thyroglobulin; Iodine radioisotopes; Neoplasm metastasis; Single photon emission computed tomography computed tomography
Contributor Information
Ying Ding
Department of Nuclear Medicine, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou 450008, China
Wenliang Li
Qiang Li
Deyu Li
Fuqiang Zhang
Xianmin Ding
Lijun Wang
Hongbiao Chen
Jianmin Jia
Hui Yang
