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Persistent or Recurrent Disease in Thyroid Cancer Survivors Who Have Elevated Serum Antithyroglobulin Antibodies

Institution:	1. Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Texas;2. Center for Health Data Science and Analytics, Houston Methodist Hospital Research Institute and Weill Cornell Medicine, Houston, Texas;1. Department of Clinical Epidemiology, Clinical Research Unit, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China;2. Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China;3. Aragón Health Research Institute, Zaragoza, Spain;4. University of Zaragoza Faculty of Medicine, Zaragoza, Spain;5. Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China;6. Medical Center of Diagnosis and Treatment for Cervical Disease, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China;1. Gynecological Endocrinology Unit, Division of Endocrinology, and Gender Identity Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil;2. Post-graduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil;3. Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil;4. Department of Molecular and Cellular Physiology, Albany Medical College, Albany, New York;5. Department of Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil;1. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Department of Endocrinology, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom;1. Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia;2. Department of Clinical Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia;3. Center for Health Outcomes & PharmacoEconomic Research, University of Arizona, Tucson, Arizona;4. Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia;5. Department of Pharmacy Practice, King Abdulaziz University Faculty of Pharmacy, Jeddah, Saudi Arabia;6. Banner—University Medicine Endocrinology and Diabetes Clinic, Tucson, Arizona;7. Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, College of Medicine, Tucson, Arizona;8. Department of Pharmacy Practice & Science, College of Pharmacy, The University of Arizona, Tucson, Arizona;1. Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland;2. Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida;3. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University, Baltimore, Maryland;4. Section on Hospital Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina;5. Center for Prevention of Cardiovascular Disease, Section on Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina;1. Endocrinology and Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México;2. Clinical Epidemiology Unit, Hospital Infantil Federico Gómez, Mexico City, México;3. Clinical Epidemiology Unit, UMAE, Hospital de Especialidades Centro Medico Siglo XXI, IMSS, Mexico City, México;4. Metabolic Diseases Research Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México

Abstract:	ObjectiveDetection of residual differentiated thyroid cancer is important but difficult. A variety of imaging modalities and biochemical markers has been used with moderately good success. We hypothesized that elevated perioperative serum antithyroglobulin antibody (TgAb) levels would also be a predictive marker for persistent or recurrent thyroid cancer.MethodsWe performed a retrospective analysis of 277 differentiated thyroid cancer survivors divided into 2 groups: (1) those with low or normal serum TgAb (TgAb−) and (2) 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.ResultsPatients in the TgAb+ group were more likely to have positive lymph nodes at initial surgery, to be assigned to a higher American Joint Committee on Cancer 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.ConclusionWe 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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