The Journal of Practical Medicine ›› 2023, Vol. 39 ›› Issue (9): 1159-1163.doi: 10.3969/j.issn.1006⁃5725.2023.09.017

• Clinical Research • Previous Articles     Next Articles

Predictive value of serum thyroglobulin and TSH for recurrence of differentiated thyroid cancer after total thyroidectomy without remnant ablation 

YU Jiangtao* ,WANG Shijie,ZHANG Gaofei,DUAN Xinxin,HUO Qingfeng,ZHENG Shouhua,LIU Peiyu.    

  1. Department of General Surgery,The Fifth Clinical Medical College (Zhengzhou People􀆳s Hospital),Henan University of Chinese Medicine,Zhengzhou 450000,China 
  • Online:2023-05-10 Published:2023-05-10

Abstract:

Objective To investigate the predictive value of serum thyroglobulin(Tg)and thyroid⁃stimu⁃ lating hormone(TSH)for recurrence in intermediate and low ⁃ risk differentiated thyroid cancer(DTC)after total thyroidectomy(TT)without remnant ablation(RA). Methods This retrospective study engaged 121 patients with intermediate and low ⁃ risk differentiated thyroid cancer who received TT in Zhengzhou People 􀆳s Hospital be⁃ tween January 2014 and July 2019,with 105 patients in non⁃recurrence group(M0)and 7 patients in recurrence group(M1). The t test,Mann⁃Whitney U test,test,and Fisher􀆳s exact test were performed to evaluate the differ⁃ ences in basic clinicopathological features among the 2 groups,and the logistic regression analysis was done to evaluate the independent influence on the recurrence of DTC patients. Spearman correlation analysis was done to ex⁃ plore the relationship between Tg and TSH. The receiver operating characteristic(ROC)curve was analyzed to evaluate the predictive value of Tg and Tg/TSH for the DTC recurrence. Results Significant differences in the se⁃ rum Tg,capsule invasion and recurrence risk were observed between the two groups(P<0.05),while no signifi⁃ cant differences were seen in gender,age,tumor size,lymph node metastasis,and TSH between them(P>0.05). Tg was found to be an independent factor for the DTC recurrence. The areas under the ROC curve of Tg for predict⁃ ing the DTC recurrence were 0.838. The cut ⁃ off value was 1.355 μg/L,and the sensitivity and specificity were 85.7% and 82.9%,respectively. Spearman correlation analysis showed that Tg was positively correlated with TSH. When Tg was ≥1.355 μg/L,the number of patients reached 18 and 16 in the M0 group and the M1 group,respec⁃ tively. There was a significant difference in Tg/TSH between the two groups(P < 0.05). The areas under the ROC curve of Tg/TSH for predicting DTC recurrence was 0.778,the cut ⁃ off value was 1.128,and the sensitivity and specificity were 66.67% and 100.0%,respectively. Conclusion The combined detection of serum Tg and TSH can be used for postoperative follow⁃up of intermediate and low⁃risk DTC patients after TT without RA,and it is of value for predicting DTC recurrence. 

Key words: differentiated thyroid cancer, neoplasm recurrence, thyroglobulin, thyroid?stimulating hormone