Research progress of thyroglobulin in evaluating lymph node metastasis of differentiated thyroid carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAN Xiao , YU Qing’an , GAO Xu ,  DAI Wenjie

Department of Thyroid Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, P. R. China;

Corresponding?author：

DAI Wenjie, Email: davidhmu@163.com

Keywords：

differentiated thyroid carcinoma; thyroglobulin; lymph node metastasis; assessment; follow-up

DOI：

10.7507/1007-9424.202102011

Video：

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Objective To explore the significance of thyroglobulin in the evaluation of lymph node metastasis during the treatment and follow-up of differentiated thyroid carcinoma.Method The literatures about thyroid globulin evaluation of lymph node metastasis of differentiated thyroid carcinoma were collected through online database and summarized.Results The determination of thyroglobulin played an important role in the perioperative evaluation of lymph node metastasis in patients with differentiated thyroid carcinoma, the guidance of postoperative radiotherapy for metastasis, and the monitoring of recurrence and metastasis, and thyroglobulin combined with imaging examination could improve its evaluation efficiency.Conclusions Thyroglobulin is an important marker for the evaluation of lymph node metastasis in the treatment and follow-up of differentiated thyroid carcinoma. Combination between thyroglobulin and imaging examination or other laboratory indicators to comprehensively explore its diagnostic threshold is a new idea, that can improve its value in the evaluation of lymph node metastasis.

Citation： YAN Xiao, YU Qing’an, GAO Xu, DAI Wenjie. Research progress of thyroglobulin in evaluating lymph node metastasis of differentiated thyroid carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(1): 124-129. doi: 10.7507/1007-9424.202102011 Copy

1.	Kilfoy BA, Zheng T, Holford TR, et al. International patterns and trends in thyroid cancer incidence, 1973-2002. Cancer Causes Control, 2009, 20(5): 525-531.
2.	Tam S, Boonsripitayanon M, Amit M, et al. Survival in differentiated thyroid cancer: comparing the AJCC cancer staging seventh and eighth editions. Thyroid, 2018, 28(10): 1301-1310.
3.	Noguchi S, Noguchi A, Murakami N. Papillary carcinoma of the thyroid. Ⅰ. Developing pattern of metastasis. Cancer, 1970, 26(5): 1053-1060.
4.	Adam MA, Pura J, Goffredo P, et al. Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer. J Clin Oncol, 2015, 33(21): 2370-2375.
5.	Baldini E, Sorrenti S, Di Gioia C, et al. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology? BMC Clin Pathol, 2013, 13: 7.
6.	Kim DW, Jeon SJ, Kim CG. Usefulness of thyroglobulin measurement in needle washouts of fine-needle aspiration biopsy for the diagnosis of cervical lymph node metastases from papillary thyroid cancer before thyroidectomy. Endocrine, 2012, 42(2): 399-403.
7.	Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid, 2016, 26(1): 1-133.
8.	中華醫學會內分泌學分會, 中華醫學會外科學分會, 中國抗癌協會頭頸腫瘤專業委員會, 等. 甲狀腺結節和分化型甲狀腺癌診治指南. 中國腫瘤臨床, 2012, 39(17): 1249-1272.
9.	Patell R, Mikhael A, Tabet M, et al. Assessing the utility of preoperative serum thyroglobulin in differentiated thyroid cancer: a retrospective cohort study. Endocrine, 2018, 61(3): 506-510.
10.	Kim H, Park SY, Choe JH, et al. Preoperative serum thyroglobulin and its correlation with the burden and extent of differentiated thyroid cancer. Cancers (Basel), 2020, 12(3): 625.
11.	Huang Z, Song M, Wang S, et al. Preoperative serum thyroglobulin is a risk factor of skip metastasis in papillary thyroid carcinoma. Ann Transl Med, 2020, 8(6): 389.
12.	周樂, 張廣, 張大奇, 等. 細針穿刺活檢及洗脫液檢測在甲狀腺癌頸淋巴結清掃決策中的應用研究. 中國實用外科雜志, 2017, 37(9): 1002-1006.
13.	Xu Y, Wu D, Wu W, et al. Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer: a systematic review and network meta-analysis. Medicine (Baltimore), 2019, 98(45): e17859.
14.	Zhu XH, Zhou JN, Qian YY, et al. Diagnostic values of thyroglobulin in lymph node fine-needle aspiration washout: a systematic review and meta-analysis diagnostic values of FNA-Tg. Endocr J, 2020, 67(2): 113-123.
15.	Sakamoto K, Imanishi Y, Tomita T, et al. Usefulness and limitation of thyroglobulin measurement in fine needle aspirates (FNA-Tg) for diagnosis of neck lymph node metastasis from thyroid carcinoma. Nihon Jibiinkoka Gakkai Kaiho, 2016, 119(5): 721-726.
16.	Jo K, Kim MH, Lim Y, et al. Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody. Eur J Endocrinol, 2015, 173(4): 489-497.
17.	Liu X, Ouyang D, Li H, et al. Papillary thyroid cancer: dual-energy spectral CT quantitative parameters for preoperative diagnosis of metastasis to the cervical lymph nodes. Radiology, 2015, 275(1): 167-176.
18.	Shin HJ, Lee HS, Kim EK, et al. A study on serum antithyroglobulin antibodies interference in thyroglobulin measurement in fine-needle aspiration for diagnosing lymph node metastasis in postoperative patients. PLoS One, 2015, 10(6): e0131096.
19.	Wang J, Jiang X, Xiao G, et al. Excellent diagnostic performance of FNA-Tg in detecting lymph nodes metastases from papillary thyroid cancer. Future Oncol, 2020, 16(33): 2735-2746.
20.	李想, 黃韜, 刁暢, 等. 甲狀腺球蛋白抗體和甲狀腺過氧化物酶抗體狀態對分化型甲狀腺癌患者中央區淋巴結影響的多中心臨床研究. 中國普外基礎與臨床雜志, 2020, 27(11): 1392-1396.
21.	Hong CM, Jeong JH, Son SH, et al. Serum thyroglobulin elevation after needle aspiration of the lymph nodes: the predictive value for detecting metastasis in papillary thyroid cancer patients—a pilot study. Medicine (Baltimore), 2019, 98(31): e16461.
22.	Wu X, Gu H, Gao Y, et al. Clinical outcomes and prognostic factors of radioiodine ablation therapy for lymph node metastases from papillary thyroid carcinoma. Nucl Med Commun, 2018, 39(1): 22-27.
23.	趙連春, 劉光霞, 陳芳, 等. 血清甲狀腺球蛋白在分化型甲狀腺癌術后轉移的診斷預測效能分析. 熱帶醫學雜志, 2020, 20(12): 1569-1572.
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25.	Ronga G, Filesi M, Ventroni G, et al. 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.
26.	Makarewicz J, Adamczewski Z, Rutkowski A, et al. An evaluation of the value of first thyroglobulin determination in the diagnostics of metastases immediately following differentiated thyroid carcinoma surgery. Endokrynol Pol, 2006, 57(4): 370-373.
27.	Demir F, ?im?ek FS, Ansal Balc? T. The role of pre-ablative stimulated thyroglobulin and thyroglobulin/thyroid-stimulating hormone ratio for predicting metastasis in thyroid cancer. Mol Imaging Radionucl Ther, 2019, 28(1): 21-26.
28.	Prabhu M, Samson S, Reddy A, et al. Role of preablative stimulated thyroglobulin in prediction of nodal and distant metastasis on iodine whole-body scan. Indian J Nucl Med, 2018, 33(2): 93-98.
29.	陳鵬, 宋長祥, 陸武, 等. 術后刺激性甲狀腺球蛋白水平預測分化型甲狀腺癌功能性轉移灶的價值. 中國醫學影像學雜志, 2017, 25(6): 422-424, 429.
30.	王芳, 王越, 刁宏翠, 等. 分化型甲狀腺癌術后再次 ¹³¹Ⅰ治療前 sTg 與 sTg/sup-Tg 對淋巴結轉移的預測價值. 現代腫瘤醫學, 2020, 28(14): 2417-2421.
31.	Park EK, Chung JK, Lim IH, et al. Recurrent/metastatic thyroid carcinomas false negative for serum thyroglobulin but positive by posttherapy I-131 whole body scans. Eur J Nucl Med Mol Imaging, 2009, 36(2): 172-179.
32.	Campennì A, Giovanella L, Pignata SA, et al. Undetectable or low (< 1 ng/mL) postsurgical thyroglobulin values do not rule out metastases in early stage differentiated thyroid cancer patients. Oncotarget, 2018, 9(25): 17491-17500.
33.	Silberstein EB. The problem of the patient with thyroglobulin elevation but negative iodine scintigraphy: the TENIS syndrome. Semin Nucl Med, 2011, 41(2): 113-120.
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36.	Spanu A, Nuvoli S, Marongiu A, et al. Neck lymph node metastasis detection in patients with differentiated thyroid carcinoma (DTC) in long-term follow-up: a ¹³¹I-SPECT/CT study. BMC Cancer, 2020, 20(1): 239.
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39.	Moslehi M, Assadi M. Contribution of ultrasound examination in the detection of neck recurrence in low-risk differentiated thyroid carcinoma patients at first follow-up visits. Nucl Med Rev Cent East Eur, 2014, 17(1): 3-6.
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42.	Rowe ME, Osorio M, Likhterov I, et al. Evaluation of ultrasound reporting for thyroid cancer diagnosis and surveillance. Head Neck, 2017, 39(9): 1756-1760.
43.	Ritter A, Mizrachi A, Bachar G, et al. Detecting recurrence following lobectomy for thyroid cancer: role of thyroglobulin and thyroglobulin antibodies. J Clin Endocrinol Metab, 2020, 105(6): dgaa152.
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1. Kilfoy BA, Zheng T, Holford TR, et al. International patterns and trends in thyroid cancer incidence, 1973-2002. Cancer Causes Control, 2009, 20(5): 525-531.
2. Tam S, Boonsripitayanon M, Amit M, et al. Survival in differentiated thyroid cancer: comparing the AJCC cancer staging seventh and eighth editions. Thyroid, 2018, 28(10): 1301-1310.
3. Noguchi S, Noguchi A, Murakami N. Papillary carcinoma of the thyroid. Ⅰ. Developing pattern of metastasis. Cancer, 1970, 26(5): 1053-1060.
4. Adam MA, Pura J, Goffredo P, et al. Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer. J Clin Oncol, 2015, 33(21): 2370-2375.
5. Baldini E, Sorrenti S, Di Gioia C, et al. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology? BMC Clin Pathol, 2013, 13: 7.
6. Kim DW, Jeon SJ, Kim CG. Usefulness of thyroglobulin measurement in needle washouts of fine-needle aspiration biopsy for the diagnosis of cervical lymph node metastases from papillary thyroid cancer before thyroidectomy. Endocrine, 2012, 42(2): 399-403.
7. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid, 2016, 26(1): 1-133.
8. 中華醫學會內分泌學分會, 中華醫學會外科學分會, 中國抗癌協會頭頸腫瘤專業委員會, 等. 甲狀腺結節和分化型甲狀腺癌診治指南. 中國腫瘤臨床, 2012, 39(17): 1249-1272.
9. Patell R, Mikhael A, Tabet M, et al. Assessing the utility of preoperative serum thyroglobulin in differentiated thyroid cancer: a retrospective cohort study. Endocrine, 2018, 61(3): 506-510.
10. Kim H, Park SY, Choe JH, et al. Preoperative serum thyroglobulin and its correlation with the burden and extent of differentiated thyroid cancer. Cancers (Basel), 2020, 12(3): 625.
11. Huang Z, Song M, Wang S, et al. Preoperative serum thyroglobulin is a risk factor of skip metastasis in papillary thyroid carcinoma. Ann Transl Med, 2020, 8(6): 389.
12. 周樂, 張廣, 張大奇, 等. 細針穿刺活檢及洗脫液檢測在甲狀腺癌頸淋巴結清掃決策中的應用研究. 中國實用外科雜志, 2017, 37(9): 1002-1006.
13. Xu Y, Wu D, Wu W, et al. Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer: a systematic review and network meta-analysis. Medicine (Baltimore), 2019, 98(45): e17859.
14. Zhu XH, Zhou JN, Qian YY, et al. Diagnostic values of thyroglobulin in lymph node fine-needle aspiration washout: a systematic review and meta-analysis diagnostic values of FNA-Tg. Endocr J, 2020, 67(2): 113-123.
15. Sakamoto K, Imanishi Y, Tomita T, et al. Usefulness and limitation of thyroglobulin measurement in fine needle aspirates (FNA-Tg) for diagnosis of neck lymph node metastasis from thyroid carcinoma. Nihon Jibiinkoka Gakkai Kaiho, 2016, 119(5): 721-726.
16. Jo K, Kim MH, Lim Y, et al. Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody. Eur J Endocrinol, 2015, 173(4): 489-497.
17. Liu X, Ouyang D, Li H, et al. Papillary thyroid cancer: dual-energy spectral CT quantitative parameters for preoperative diagnosis of metastasis to the cervical lymph nodes. Radiology, 2015, 275(1): 167-176.
18. Shin HJ, Lee HS, Kim EK, et al. A study on serum antithyroglobulin antibodies interference in thyroglobulin measurement in fine-needle aspiration for diagnosing lymph node metastasis in postoperative patients. PLoS One, 2015, 10(6): e0131096.
19. Wang J, Jiang X, Xiao G, et al. Excellent diagnostic performance of FNA-Tg in detecting lymph nodes metastases from papillary thyroid cancer. Future Oncol, 2020, 16(33): 2735-2746.
20. 李想, 黃韜, 刁暢, 等. 甲狀腺球蛋白抗體和甲狀腺過氧化物酶抗體狀態對分化型甲狀腺癌患者中央區淋巴結影響的多中心臨床研究. 中國普外基礎與臨床雜志, 2020, 27(11): 1392-1396.
21. Hong CM, Jeong JH, Son SH, et al. Serum thyroglobulin elevation after needle aspiration of the lymph nodes: the predictive value for detecting metastasis in papillary thyroid cancer patients—a pilot study. Medicine (Baltimore), 2019, 98(31): e16461.
22. Wu X, Gu H, Gao Y, et al. Clinical outcomes and prognostic factors of radioiodine ablation therapy for lymph node metastases from papillary thyroid carcinoma. Nucl Med Commun, 2018, 39(1): 22-27.
23. 趙連春, 劉光霞, 陳芳, 等. 血清甲狀腺球蛋白在分化型甲狀腺癌術后轉移的診斷預測效能分析. 熱帶醫學雜志, 2020, 20(12): 1569-1572.
24. 高劉艷, 李素平. 甲狀腺球蛋白和甲狀腺球蛋白抗體在分化型甲狀腺癌診治中的價值. 國際放射醫學核醫學雜志, 2020, 44(3): 196-201.
25. Ronga G, Filesi M, Ventroni G, et al. 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.
26. Makarewicz J, Adamczewski Z, Rutkowski A, et al. An evaluation of the value of first thyroglobulin determination in the diagnostics of metastases immediately following differentiated thyroid carcinoma surgery. Endokrynol Pol, 2006, 57(4): 370-373.
27. Demir F, ?im?ek FS, Ansal Balc? T. The role of pre-ablative stimulated thyroglobulin and thyroglobulin/thyroid-stimulating hormone ratio for predicting metastasis in thyroid cancer. Mol Imaging Radionucl Ther, 2019, 28(1): 21-26.
28. Prabhu M, Samson S, Reddy A, et al. Role of preablative stimulated thyroglobulin in prediction of nodal and distant metastasis on iodine whole-body scan. Indian J Nucl Med, 2018, 33(2): 93-98.
29. 陳鵬, 宋長祥, 陸武, 等. 術后刺激性甲狀腺球蛋白水平預測分化型甲狀腺癌功能性轉移灶的價值. 中國醫學影像學雜志, 2017, 25(6): 422-424, 429.
30. 王芳, 王越, 刁宏翠, 等. 分化型甲狀腺癌術后再次 ¹³¹Ⅰ治療前 sTg 與 sTg/sup-Tg 對淋巴結轉移的預測價值. 現代腫瘤醫學, 2020, 28(14): 2417-2421.
31. Park EK, Chung JK, Lim IH, et al. Recurrent/metastatic thyroid carcinomas false negative for serum thyroglobulin but positive by posttherapy I-131 whole body scans. Eur J Nucl Med Mol Imaging, 2009, 36(2): 172-179.
32. Campennì A, Giovanella L, Pignata SA, et al. Undetectable or low (< 1 ng/mL) postsurgical thyroglobulin values do not rule out metastases in early stage differentiated thyroid cancer patients. Oncotarget, 2018, 9(25): 17491-17500.
33. Silberstein EB. The problem of the patient with thyroglobulin elevation but negative iodine scintigraphy: the TENIS syndrome. Semin Nucl Med, 2011, 41(2): 113-120.
34. Song HJ, Xue YL, Qiu ZL, et al. Uncommon metastases from differentiated thyroid carcinoma. Hell J Nucl Med, 2012, 15(3): 233-240.
35. 夏亮, 陸滌宇, 周俊, 等. ¹³¹I-SPECT/CT 多模態顯像聯合超聲及血清 Tg 對分化型甲狀腺癌頸部淋巴結轉移的診斷價值. 腫瘤學雜志, 2017, 23(4): 278-281.
36. Spanu A, Nuvoli S, Marongiu A, et al. Neck lymph node metastasis detection in patients with differentiated thyroid carcinoma (DTC) in long-term follow-up: a ¹³¹I-SPECT/CT study. BMC Cancer, 2020, 20(1): 239.
37. 范志娜, 吳剛, 袁建軍. 超聲聯合血清 Tg、SPECT/CT 診斷分化型甲狀腺癌術后頸部淋巴結轉移. 中國醫學影像技術, 2014, 30(3): 362-365.
38. 張瑞堅, 劉立衡, 劉巧愛, 等. 頸部超聲聯合甲狀腺球蛋白檢查對分化性甲狀腺癌術后復發診斷的臨床價值. 中國現代普通外科進展, 2019, 22(7): 515-517.
39. Moslehi M, Assadi M. Contribution of ultrasound examination in the detection of neck recurrence in low-risk differentiated thyroid carcinoma patients at first follow-up visits. Nucl Med Rev Cent East Eur, 2014, 17(1): 3-6.
40. Zhao T, Liang J, Li T, et al. Value of serial preablative thyroglobulin measurements: can we address the impact of thyroid remnants? Nucl Med Commun, 2016, 37(6): 632-639.
41. 趙騰, 梁軍, 李田軍, 等. 分化型甲狀腺癌 ¹³¹I 治療前刺激性 Tg 動態變化與遠處轉移的關系. 中國醫學科學院學報, 2015, 37(3): 315-319.
42. Rowe ME, Osorio M, Likhterov I, et al. Evaluation of ultrasound reporting for thyroid cancer diagnosis and surveillance. Head Neck, 2017, 39(9): 1756-1760.
43. Ritter A, Mizrachi A, Bachar G, et al. Detecting recurrence following lobectomy for thyroid cancer: role of thyroglobulin and thyroglobulin antibodies. J Clin Endocrinol Metab, 2020, 105(6): dgaa152.
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Research progress of thyroglobulin in evaluating lymph node metastasis of differentiated thyroid carcinoma

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