The Role of Recombinant Human Thyrotropin for Diagnostic Monitoring of Patients with Differentiated Thyroid Cancer |
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| Institution: | 1. Endocrinology and Metabolism Institute, Cleveland Clinic Foundation, Cleveland, Ohio;2. Education Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio;3. Yale Pediatric Endocrinology Department, Yale University School of Medicine, New Haven, Connecticut;4. Yale Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut;5. Pathology and Laboratory Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio;1. Endocrinology and Reproductive Physiology Laboratory, Department of Physiology, University of Calcutta, West Bengal, India;2. Department of Zoology, D.M. College of Science, Manipur, India;3. Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Boston, Massachusetts;1. University of Maryland School of Medicine, Baltimore, Maryland;2. Baltimore Washington Medical Center Baltimore, Maryland;3. University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;4. Boston University Medical Center, Boston, Massachusetts;1. Sapienza University of Rome Experimental Medicine Department Medical Physiopathology, Food Science and Endocrinology Section Food Science and Human Nutrition Research Unit;1. Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;2. Maccabi Healthcare Services, Israel;3. Center for Clinical Quality and Safety, Jerusalem, Israel;4. Endocrinology and Metabolism Service, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;1. Diabetes Care Center, Salinas, California, United States;2. IDIBELL-Hospital Universitari Bellvitge, CIBERDEM, Barcelona, Spain;;3. Florida Hospital, Orlando, Florida, United States;4. Department of Endocrinology, Ochsner Medical Center, New Orleans, Louisiana, United States;5. Novo Nordisk A/S, Sϕborg, Denmark;;6. Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Italy. |
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| Abstract: | ObjectiveTo describe the evolving role of recombinant human thyrotropin in the diagnostic evaluation of patients treated for differentiated thyroid carcinoma.MethodsA systematic review was performed of published English language articles appearing in PubMed using terms “recombinant thyrotropin” and “thyroid cancer”. The author selected articles for inclusion based upon potential for clinical impact of the reported findings.ResultsThe addition of recombinant human thyrotropin to diagnostic testing replaced the requirement for thyroid hormone withdrawal and symptomatic hypothyroidism that had been necessary to generate sufficient endogenous thyrotropin for radioiodine scanning and thyroglobulin testing. The high negative predictive value of stimulated thyroglobulin testing removed the need for serial radioiodine scanning for many patients, but repeated stimulated testing rarely appeared to add significantly. The development of highly sensitive second generation thyroglobulin assays may replace the need for stimulated testing in a subset of patients.ConclusionRecombinant human thyrotropin-stimulated testing continues to be a valuable component of follow-up testing in the first year after initial treatment of differentiated thyroid cancer. (Endocr Pract. 2013;19: 157-161) |
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