The Complementary Role of Radioimmunoassay for Immunometric Assay of Thyroglobin_West China Medical Journal

Authors：

 HEJian ¹ , PANMing-zhi ² , HUANGRui ² ,  TANGGong-shun ²

1. Department of Nuclear Medicine, the Second People's Hospital of Chengdu, Chengdu, Sichuan 610017, P. R. China;
2. Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

TANGGong-shun, Email: tgs010@163.com

Keywords：

Thyroid cancer; Thyroglobulin; Anti-thyroglobulin; Radioimmunoassay; Immunometric assay

DOI：

10.7507/1002-0179.20140454

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Objective To evaluate whether thyroglobin (Tg) value by radioimmunoassay (Tg-RIA) can be used as a complementary marker in differentiated thyroid cancer (DTC) patients, as serum Tg value is the key marker for the follow-up of patients with DTC, and endogenous antithyroglobulin (TgAb) interferes with serum Tg value by immunometric assay (Tg-IMA). Methods Fifty-five in-hospital patients with DTC after total thyroidectomy and ¹³¹I ablation during September and December 2012 were enrolled. Tg-IMA tests and Tg-RIA tests were performed separately. Diagnostic criteria about relapse, metastasis or disease-free status of thyroid carcinoma were established by serum Tg, diagnostic whole body scan (D-WBS), neck ultrasonography, chest CT and patients' history. Results Two DTC patients showed false negative Tg-IMA and true positive Tg-RIA. Five patients had false negative Tg-RIA because of low sensitivity of RIA. Four patients with weak positive Tg-IMA (1.07-4.09 μg/L) required follow-up. Among the 11 DTC patients with strong TgAb positivity (>115 kU/L), two patients with positive Tg-IMA and positive Tg-RIA received second operation or radioiodine therapy, seven patients had positive Tg-RIA and negative Tg-IMA. Five of the seven patients with strong positive TgAb needed further follow-up, and two of them received radioiodine therapy. Conclusion Tg value with radioimmunoassay is a complementary marker to find false negative Tg-IMA in follow-up patients with DTC.

Citation： HEJian, PANMing-zhi, HUANGRui, TANGGong-shun. The Complementary Role of Radioimmunoassay for Immunometric Assay of Thyroglobin. West China Medical Journal, 2014, 29(8): 1479-1482. doi: 10.7507/1002-0179.20140454 Copy

1.	唐恭順, 胥勁, 俞英, 等. 分化型甲狀腺癌患者血清Tg測定值與內源性TgAb濃度的相關性研究[J]. 四川大學學報·醫學版, 2011, 42(6):856-860.
2.	吳瑕, 胥勁, 倪建, 等. 稀釋曲線法評價TgAb對Tg測定的干擾[J]. 四川大學學報·醫學版, 2013, 44(3):432-435.
3.	張文杰, 鄧候富, 潘明志, 等. 分化型甲狀腺癌患者內源性TgAb對血清Tg測定值、Tg陽性率的影響[J]. 生物醫學工程學雜志, 2013, 30(4):803-807.
4.	Spencer CA, Bergoglio LM, Kazarosyan M, et al. Clinical impact of thyroglobulin (Tg) and Tg autoantibody method differences on the management of patients with differentiated thyroid carcinomas[J]. J Clin Endocrinol Metab, 2005, 90(10):5566-5575.
5.	Garas G, Jarral O, Tolley N, et al. Is there survival benefit from life-long follow-up after treatment for differentiated thyroid cancer?[J]. Int J Surg, 2013, 11(2):116-121.
6.	Piccardo A, Arecco F, Puntoni M, et al. Focus on High-Risk DTC patients high postoperative serum thyroglobulin level is a strong predictor of disease persistence and is associated to Progression-Free survival and overall survival[J]. Clin Nucl Med, 2013, 38(1):18-24.
7.	Rosario PW, Mineiro Filho AF, Prates BS, et al. Postoperative stimulated thyroglobulin of less than 1 ng/ml as a criterion to spare low-risk patients with papillary thyroid cancer from radioactive Iodine ablation[J]. Thyroid, 2012, 22(11):1140-1143.
8.	Rosario PW, Furtado Mde S, Mineiro Filho AF, et al. Value of diagnostic radioiodine whole-body scanning after initial therapy in patients with differentiated thyroid cancer at intermediate and high risk for recurrence[J]. Thyroid, 2012, 22(11):1165-1169.
9.	Lim I, Kim SK, Hwang SS, et al. Prognostic implication of thyroglobulin and quantified whole body scan after initial radioiodine therapy on early prediction of ablation and clinical response for the patients with differentiated thyroid cancer[J]. Ann Nucl Med, 2012, 26(10):777-786.
10.	Park do J, Lim JA, Kim TH, et al. Serum thyroglobulin level measured after thyroxine withdrawal is useful to predict further recurrence in whole body scan-negative papillary thyroid cancer patients after reoperation[J]. Endocr J, 2012, 59(11):1021-1030.
11.	Han JM, Kim WB, Yim JH, et al. Long-Term clinical outcome of differentiated thyroid cancer patients with undetectable stimulated thyroglobulin level one year after initial treatment[J]. Thyroid, 2012, 22(8):784-790.
12.	Durante C, Montesano T, Attard M, et al. Long-term surveillance of papillary thyroid cancer patients who do not undergo postoperative radioiodine remnant ablation:is there a role for serum thyroglobulin measurement?[J]. J Clin Endocrinol Metab, 2012, 97(8):2748-2753.
13.	Webb RC, Howard RS, Stojadinovic A, et al. The utility of serum thyroglobulin measurement at the time of remnant ablation for predicting disease-free status in patients with differentiated thyroid cancer:a meta-analysis involving 3947 patients[J]. J Clin Endocrinol Metab, 2012, 97(8):2754-2763.
14.	Hughes DT, Laird AM, Miller BS, et al. Reoperative lymph node dissection for recurrent papillary thyroid cancer and effect on serum thyroglobulin[J]. Ann Surg Oncol, 2012, 19(9):2951-2957.
15.	Weightman DR, Mallick UK, Fenwick JD, et al. Discordant serum thyroglobulin results generated by two classes of assay in patients with thyroid carcinoma-correlation with clinical outcome after 3 years of follow-up[J]. Cancer, 2003, 98(1):41-47.
16.	Persoon AC, Links TP, Wilde J, et al. Thyroglobulin (Tg) recovery testing with quantitative Tg antibody measurement for determining interference in serum Tg assays in differentiated thyroid carcinoma[J]. Clin Chem, 2006, 52(6):1196-1199.
17.	Pacini F, Sabra MM, Tuttle RM. Clinical relevance of thyroglobulin doubling time in the management of patients with differentiated thyroid cancer[J]. Thyroid, 2011, 21(7):691-692.
18.	Boldarine VT, Maciel RM, Guimaraes GS, et al. Development of a sensitive and specific quantitative reverse transcription-polymerase chain reaction assay for blood thyroglobulin messenger ribonucleic acid in the follow-up of patients with differentiated thyroid carcinoma[J]. J Clin Endocrinol Metab, 2010, 95(4):1726-1733.

1. 唐恭順, 胥勁, 俞英, 等. 分化型甲狀腺癌患者血清Tg測定值與內源性TgAb濃度的相關性研究[J]. 四川大學學報·醫學版, 2011, 42(6):856-860.
2. 吳瑕, 胥勁, 倪建, 等. 稀釋曲線法評價TgAb對Tg測定的干擾[J]. 四川大學學報·醫學版, 2013, 44(3):432-435.
3. 張文杰, 鄧候富, 潘明志, 等. 分化型甲狀腺癌患者內源性TgAb對血清Tg測定值、Tg陽性率的影響[J]. 生物醫學工程學雜志, 2013, 30(4):803-807.
4. Spencer CA, Bergoglio LM, Kazarosyan M, et al. Clinical impact of thyroglobulin (Tg) and Tg autoantibody method differences on the management of patients with differentiated thyroid carcinomas[J]. J Clin Endocrinol Metab, 2005, 90(10):5566-5575.
5. Garas G, Jarral O, Tolley N, et al. Is there survival benefit from life-long follow-up after treatment for differentiated thyroid cancer?[J]. Int J Surg, 2013, 11(2):116-121.
6. Piccardo A, Arecco F, Puntoni M, et al. Focus on High-Risk DTC patients high postoperative serum thyroglobulin level is a strong predictor of disease persistence and is associated to Progression-Free survival and overall survival[J]. Clin Nucl Med, 2013, 38(1):18-24.
7. Rosario PW, Mineiro Filho AF, Prates BS, et al. Postoperative stimulated thyroglobulin of less than 1 ng/ml as a criterion to spare low-risk patients with papillary thyroid cancer from radioactive Iodine ablation[J]. Thyroid, 2012, 22(11):1140-1143.
8. Rosario PW, Furtado Mde S, Mineiro Filho AF, et al. Value of diagnostic radioiodine whole-body scanning after initial therapy in patients with differentiated thyroid cancer at intermediate and high risk for recurrence[J]. Thyroid, 2012, 22(11):1165-1169.
9. Lim I, Kim SK, Hwang SS, et al. Prognostic implication of thyroglobulin and quantified whole body scan after initial radioiodine therapy on early prediction of ablation and clinical response for the patients with differentiated thyroid cancer[J]. Ann Nucl Med, 2012, 26(10):777-786.
10. Park do J, Lim JA, Kim TH, et al. Serum thyroglobulin level measured after thyroxine withdrawal is useful to predict further recurrence in whole body scan-negative papillary thyroid cancer patients after reoperation[J]. Endocr J, 2012, 59(11):1021-1030.
11. Han JM, Kim WB, Yim JH, et al. Long-Term clinical outcome of differentiated thyroid cancer patients with undetectable stimulated thyroglobulin level one year after initial treatment[J]. Thyroid, 2012, 22(8):784-790.
12. Durante C, Montesano T, Attard M, et al. Long-term surveillance of papillary thyroid cancer patients who do not undergo postoperative radioiodine remnant ablation:is there a role for serum thyroglobulin measurement?[J]. J Clin Endocrinol Metab, 2012, 97(8):2748-2753.
13. Webb RC, Howard RS, Stojadinovic A, et al. The utility of serum thyroglobulin measurement at the time of remnant ablation for predicting disease-free status in patients with differentiated thyroid cancer:a meta-analysis involving 3947 patients[J]. J Clin Endocrinol Metab, 2012, 97(8):2754-2763.
14. Hughes DT, Laird AM, Miller BS, et al. Reoperative lymph node dissection for recurrent papillary thyroid cancer and effect on serum thyroglobulin[J]. Ann Surg Oncol, 2012, 19(9):2951-2957.
15. Weightman DR, Mallick UK, Fenwick JD, et al. Discordant serum thyroglobulin results generated by two classes of assay in patients with thyroid carcinoma-correlation with clinical outcome after 3 years of follow-up[J]. Cancer, 2003, 98(1):41-47.
16. Persoon AC, Links TP, Wilde J, et al. Thyroglobulin (Tg) recovery testing with quantitative Tg antibody measurement for determining interference in serum Tg assays in differentiated thyroid carcinoma[J]. Clin Chem, 2006, 52(6):1196-1199.
17. Pacini F, Sabra MM, Tuttle RM. Clinical relevance of thyroglobulin doubling time in the management of patients with differentiated thyroid cancer[J]. Thyroid, 2011, 21(7):691-692.
18. Boldarine VT, Maciel RM, Guimaraes GS, et al. Development of a sensitive and specific quantitative reverse transcription-polymerase chain reaction assay for blood thyroglobulin messenger ribonucleic acid in the follow-up of patients with differentiated thyroid carcinoma[J]. J Clin Endocrinol Metab, 2010, 95(4):1726-1733.

West China Medical Journal

The Complementary Role of Radioimmunoassay for Immunometric Assay of Thyroglobin

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