Persistent or recurrent disease in thyroid cancer survivors who have elevated serum anti-thyroglobulin antibodies

Objective

Detection of residual differentiated thyroid cancer is important but difficult. A variety of imaging modalities and biochemical markers have been used with moderately good success. We hypothesized that elevated perioperative serum anti-thyroglobulin antibodies (TgAb) would also be a predictive marker for persistent or recurrent thyroid cancer.

Methods

We performed a retrospective analysis of 277 differentiated thyroid cancer survivors divided into two groups: those with low or normal serum TgAb (TgAb-) and those with elevated serum TgAb (TgAb+). All patients were seen at one major academic medical center. Patients were followed for a median of 7.54 years.

Results

Patients in the TgAb+ group were more likely to have positive lymph nodes at initial surgery, to be assigned to a higher AJCC Stage, and to have significantly higher incidence of persistent/recurrent disease. The higher incidence of persistent/recurrent cancer was significant under univariable and multivariable (including TgAb status, age, and sex) Cox proportional hazards model analysis.

Conclusion

We conclude that individuals with elevated serum TgAb at the outset should be followed with a higher index of suspicion for persistent/recurrent thyroid cancer.

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