Istituto di Fisiologia Clinica     
Iervasi G., Iervasi A., Ferdeghini M., Solimeo C., Bottoni A., Rossi L., Colato C., Zucchelli G. Clinical relevance of highly-sensitive Tg assay in monitoring low-risk patients treated for differentiated thyroid cancer on suppressive L-Thyroxine therapy. In: Clinical Endocrinology, vol. 67 (3) pp. 434 - 441. Blackwell Publisher, 2007.
Objective: Serum Thyroglobulin (Tg) represents a high specific biomarker for the detection of residual functioning thyroid tissue and/or recurrence/metastases in the follow-up of treated patients for differentiated thyroid cancer (DTC). Recently, several highly sensitive Tg assays have been developed but their clinical benefit still remains undetermined. Design: We evaluated the clinical impact of Tg values measured by a highly sensitive Tg assay (Access, Beckman) during L-Thyroxine (L-T4) suppressive therapy in a group of 106 low-risk DTC-treated patients, submitted to routinely follow-up including Recombinant Human Thyrotropin stimulation (rh-TSH). Main Outcome: Undetectable (i.e. <0.1 mg/L) Tg Access showed a very high negative predictive value (99%) of a Tg negative response (i.e. <2 mg/L) to rh-TSH. Minimal amounts of measurable Tg, (i.e. >0.1 but <1 mg/L) during L-T4 therapy correctly identified the majority of patients (80%) with a positive (>2 mg/L) response to rh-TSH. Conclusions: Our results indicate that routinely introduction of a highly-sensitive Tg assay may represent a useful diagnostic tool which helps to better interpret Tg results during monitoring of DTC-treated low-risk patients on L-T4 suppressive therapy and to optimize the execution of the more expensive rh-TSH test.
URL: http://www.blackwellpublishing.com
DOI: 10.1111/j.1365-2265.2007.02907.x
Subject Differentiated Thyroid Cancer
Chemiluminescent immunoassay

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