versión On-line ISSN 2078-5151
versión impresa ISSN 0038-2361
S. Afr. j. surg. vol.49 no.3 Cape Town ago. 2011
M. S. PapageorgiouI; N. LiratzopoulosII; G. MinopoulosII; K. J. ManolasII
IM.D., Ph.D; Ist Department of Surgery, University General Hospital of Alexandroupolis, Greece
IIProfessor Of SURGERY; Ist Department of Surgery, University General Hospital of Alexandroupolis, Greece
BACKGROUND: Thyroglobulin (Tg) is used as a postoperative marker for the follow-up of patients with thyroid carcinoma, but there is no consensus regarding the value that may indicate possible recurrence.
AIM: To evaluate Tg levels as a marker for recurrence of thyroid carcinoma.
SUBJECTS AND METHODS: Demographics and survival of 80 patients who underwent total thyroidectomy for well-differentiated thyroid cancer were analysed and related to Tg levels. Tg measurements were performed when patients were euthyroid, after completion of treatment.
RESULTS: The median Tg value was 1.3 ng/ml. Higher values were found in males, high-risk patients and patients with recurrent disease. Using the median Tg value as cut-off, patients were divided into two groups (group I <1.3 ng/ml and group II >1.3 ng/ml). There was a significant correlation between values >1.3 ng/ml and recurrence. When survival was related to Tg values, there was a tendency towards worse prognosis in group II. The best predictive cut-off value for recurrence was found to be 1.3 ng/ml, which had a sensitivity of 77% and a specificity of 57%.
CONCLUSIONS: Although low, a cut-off Tg level of 1.3 ng/ml represents a simple indication for further investigation in patients receiving thyroxine after completion of treatment for thyroid cancer, in the absence of measurement of anti-Tg auto-antibodies.
“Full text available only in PDF format”
1. Memon A, Berrington De Gonzalez A, Luqmani Y, Suresh A. Family history of benign thyroid disease and cancer and risk of thyroid cancer. Eur J Cancer 2004;40:754-760. [ Links ]
2. Busnardo B, De Vido D. The epidemiology and etiology of differentiated thyroid carcinoma. Biomed Pharmacother 2000;54:322-326. [ Links ]
3. Tyler DS, Shaha AR, Udelsman RA, et al. Thyroid cancer: 1999 update. Ann Surg Oncol 2000;7(5):376-398. [ Links ]
4. Hanks JB. Thyroid. In: Townsend CM, Beauchamp DR, Evers MB, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 17th ed. Philadelphia: Elsevier Saunders, 2004:947-984. [ Links ]
5. Lima N, Cavaliere H, Tomimori E, et al. Prognostic value of serum thyroglobulin determinations after total thyroidectomy for differentiated thyroid cancer. J Endo- crinol Invest 2002;25(2):110-115. [ Links ]
6. Ronga G, Filesi M, Ventroni G, Vestri AR, Signore A. Value of the first serum thyroglobulin level after total thyroidectomy for the diagnosis of metastases from differentiated thyroid carcinoma. Eur J Nucl Med 1999;26(11):1448-1452. [ Links ]
7. Lin JD, Huang MJ, Hsu BR, et al. Significance of postoperative serum thyroglobulin levels in patients with papillary and follicular thyroid carcinomas. J Surg Oncol 2002;80(1):45-51. [ Links ]
8. Pacini F, Pinchera A. Serum and tissue thyroglobulin measurement: clinical applications in thyroid disease. Biochimie 1999;81:463-467. [ Links ]
9. Mariotti S, Barbesino G, Caturegli P, et al. Assay of thyroglobulin in serum with thyroglobulin autoantibodies: an unobtainable goal? J Clin Endocrinol Metab 1995;80:468-472. [ Links ]
10. Whitley RJ, Ain KB. Thyroglobulin:a specific serum marker for the management of thyroid carcinoma. Clin Lab Med 2004;24:29-47. [ Links ]
11. Salvatore B, Paone G, Klain M, et al. Fluorodeoxyglucose PET/CT in patients with differentiated thyroid cancer and elevated thyroglobulin after total thyroidectomy and 131I ablation. Q J Nucl Med Mol Imaging 2008;52:2-8. [ Links ]
12. Mazzaferri EL, Robbins RJ, Braverman LE, et al. A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma. J Clin Endocrinol Metab 2004;88:4508-4509. [ Links ]
13. Spencer CA, LoPresti JS, Fatemi S, Nicoloff JT. Detection of residual and recurrent differentiated thyroid carcinoma by serum thyroglobulin measurement. Thyroid 1999;9(5):435-441. [ Links ]
14. Duren M, Siperstein AE, Shen W, Duh QY, Morita E, Clark OH. Value of stimulated serum thyroglobulin levels for detecting persistent or reccurent differentiated thyroid cancer in high- and low-risk patients. Surgery 1999;126:13-19. [ Links ]
15. Hamy A, Mirallie E, Bennouna J, et al. Thyroglobulin monitoring after treatment of well-differentiated thyroid cancer. Eur J Surg Oncol 2004;30(6):681-685. [ Links ]
16. van Sorge-van Boxtel RA, van Eck-Smit BL, Goslings BM. Comparison of serum thyroglobulin, 131I and 201TI scintigraphy in the postoperative follow-up of differentiated thyroid cancer. Nucl Med Commun 1993;14(5):365-372. [ Links ]
Adding smiles to childrens lives
Twenty children underwent reconstructive surgery during the Adding Smiles to Life with Adcock Ingram Smile Week held from 25 to 29 July at Red Cross Hospital War Memorial Childrens Hospital, Cape Town. Thanks to the Smile Foundation and Adcock Ingram Healthcare, these childrens parents, families and communities can celebrate the fact that they have a beautiful smile and can go off to school when theyre older without fear of being teased or isolated, said Moira Gerszt, Chief Operating Officer of the Smile Foundation.
The Smile Foundations partnership with Adcock Ingram began last year. Adcock Ingram is humbled by being part of this philanthropic initiative, said Dr Jonathan Louw, CEO for Adcock Ingram Healthcare.
The funding that Adcock Ingram contributes towards these life-changing operations not only lessens the deformity of these children, but ensures that the every child is able to swallow both solids and liquids with ease. Our partnership with Smile Foundation reiterates our commitment to adding value to life, and changing one child at a time, said Louw.
The Smile Foundation has partnered with academic hospitals in South Africa to help underprivileged children with facial conditions, alleviating backlogs in the hospitals, encouraging skills transfer, offering psychological help before and after surgery, and supporting hospital infrastructure.
The Smile Foundations partnership with Red Cross Childrens Hospital is now in its second year. As part of the partnership the Smile Foundation funds the additional resources necessary and pays for the surgery. The hospital provides the infrastructure, staff, care, treatment and expertise.
The success of the Smile Week model has been widespread. To date almost 700 children around the country have benefited from surgery through the partnership with state academic hospitals. In the Western Cape, 80 children have been helped during the various Smile Weeks held in the province.
For more information, contact Sanri van
Wyk, Taryn Fritz Public Relations.