Thyroglobulin measurement using highly sensitive assays in patients with differentiated thyroid cancer: a clinical position paper.

Abstract:

:Differentiated thyroid cancer (DTC) is the most common endocrine cancer and its incidence has increased in recent decades. Initial treatment usually consists of total thyroidectomy followed by ablation of thyroid remnants by iodine-131. As thyroid cells are assumed to be the only source of thyroglobulin (Tg) in the human body, circulating Tg serves as a biochemical marker of persistent or recurrent disease in DTC follow-up. Currently, standard follow-up for DTC comprises Tg measurement and neck ultrasound combined, when indicated, with an additional radioiodine scan. Measurement of Tg after stimulation by endogenous or exogenous TSH is recommended by current clinical guidelines to detect occult disease with a maximum sensitivity due to the suboptimal sensitivity of older Tg assays. However, the development of new highly sensitive Tg assays with improved analytical sensitivity and precision at low concentrations now allows detection of very low Tg concentrations reflecting minimal amounts of thyroid tissue without the need for TSH stimulation. Use of these highly sensitive Tg assays has not yet been incorporated into clinical guidelines but they will, we believe, be used by physicians caring for patients with DTC. The aim of this clinical position paper is, therefore, to offer advice on the various aspects and implications of using these highly sensitive Tg assays in the clinical care of patients with DTC.

journal_name

Eur J Endocrinol

authors

Giovanella L,Clark PM,Chiovato L,Duntas L,Elisei R,Feldt-Rasmussen U,Leenhardt L,Luster M,Schalin-Jäntti C,Schott M,Seregni E,Rimmele H,Smit J,Verburg FA

doi

10.1530/EJE-14-0148

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

R33-46

issue

2

eissn

0804-4643

issn

1479-683X

pii

EJE-14-0148

journal_volume

171

pub_type

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