Lymphocytic Thyroiditis on Histology Correlates with Serum Thyroglobulin Autoantibodies in Patients with Papillary Thyroid Carcinoma: Impact on Detection of Serum Thyroglobulin
Francesco Latrofa,Debora Ricci,Lucia Montanelli,Roberto Rocchi,Paolo Piaggi,Eleonora Sisti,Lucia Grasso,Fulvio Basolo,Clara Ugolini,Aldo Pinchera,Paolo Vitti +10 more
TLDR
In papillary thyroid carcinoma, LT on histology must be carefully searched for because it is frequently associated with TgAb and therefore mistakenly low or undetectable Tg, which can be underestimated in patients with T g autoantibodies (TgAb).Abstract:
Context: Serum thyroglobulin (Tg), the marker of residual tumor in papillary thyroid carcinoma, can be underestimated in patients with Tg autoantibodies (TgAb) TgAb are due to a coexistent lymphocytic thyroiditis (LT) or the papillary thyroid carcinoma per se TgAb assays are highly discordant Design: We evaluated 141 patients with a clinical diagnosis of nodular thyroid disease, 32 of Hashimoto's thyroiditis, and four of Graves' disease, who underwent total thyroidectomy for an associated papillary thyroid carcinoma Patients were classified as papillary thyroid carcinoma-lymphocytic thyroiditis (PTC-T) and papillary thyroid carcinoma (PTC) according to the presence or absence of LT on histology Tg was measured before thyroid remnant ablation, when it is expectedly detectable, by an immunometric assay (IMA) and TgAb by three noncompetitive IMA and three competitive radioimmunoassays (RIA) The number of lymphocytes was compared with TgAb concentration Results: Seventy-two of 177 patients (407%) wereread more
Citations
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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.
Bryan R. Haugen,Erik K. Alexander,Keith C. Bible,Gerard M. Doherty,Susan J. Mandel,Yuri E. Nikiforov,Furio Pacini,Gregory W. Randolph,Anna M. Sawka,Martin Schlumberger,Kathryn G. Schuff,Steven I. Sherman,Julie Ann Sosa,David L. Steward,R. Michael Tuttle,Leonard Wartofsky +15 more
TL;DR: Evidence-based recommendations are developed to inform clinical decision-making in the management of thyroid nodules and differentiated thyroid cancer and represent, in the authors' opinion, contemporary optimal care for patients with these disorders.
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2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: What is new and what has changed?
TL;DR: The author notes 3 new basic principles that have emerged in this guidelines revision: the management of thyroid nodules, including the decision to perform a fine‐needle aspiration biopsy as well as follow-up decision making will be heavily influenced by the newly developed sonographic risk pattern.
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Implications of thyroglobulin antibody positivity in patients with differentiated thyroid cancer: a clinical position statement.
Frederik A. Verburg,Markus Luster,Cristina Cupini,Luca Chiovato,Leonidas H. Duntas,Rossella Elisei,Ulla Feldt-Rasmussen,Harald Rimmele,Ettore Seregni,Johannes W. A. Smit,Christian Theimer,Luca Giovanella +11 more
TL;DR: A thorough discussion by a group of physician-scientists, all of whom have a distinguished track record in thyroid cancer care, was held to arrive at a consensus expert opinion on how to proceed with treatment and follow-up in TgAb-positive DTC patients.
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Thyroglobulin antibody (TgAb) methods - Strengths, pitfalls and clinical utility for monitoring TgAb-positive patients with differentiated thyroid cancer
Carole A. Spencer,Shireen Fatemi +1 more
TL;DR: This review focuses on the technical limitations of current TgAb methods, characteristics of T gAb interference with different classes of Tg method, and the clinical value of monitoring Tg Ab trends as a surrogate DTC tumor marker.
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How sensitive (second-generation) thyroglobulin measurement is changing paradigms for monitoring patients with differentiated thyroid cancer, in the absence or presence of thyroglobulin autoantibodies
TL;DR: The growing use of Tg2GIMA measurement is changing paradigms for postoperative DTC monitoring, and the trend and doubling time of low basal thyroglobulin values arising from postsurgical thyroid remnants have recognized prognostic significance.
References
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Samara Pena,Seth Arum,Mary Cross,Barbarajean Magnani,Elizabeth N. Pearce,M. Elizabeth Oates,Lewis E. Braverman +6 more
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Thyroglobulin-thyroperoxidase autoantibodies are polyreactive, not bispecific: analysis using human monoclonal autoantibodies.
TL;DR: This finding, albeit from a single patient, questions previous observations of serum TgPOAb prepared by affinity chromatography and provides powerful evidence against shared, cross-reactive epitopes on 2 major thyroid autoantigens.
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TL;DR: The TgAb panel provides novel information regarding the repertoire of H chain genes encoding human TgAbs as well as the relationship between the H chains and the epitopes recognized on this major thyroid autoantigen.
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Characterization of thyroglobulin epitopes in Sardinian adults and juveniles with Hashimoto's thyroiditis: evidence against a major effect of age and genetic background on B-cell epitopes.
Francesco Latrofa,Debora Ricci,Paolo Vitti,Alessia Prinzis,Valentina M. Cambuli,Mariangela Ghiani,Sabrina Pilia,D. Carta,Sandro Loche,Aldo Pinchera,Stefano Mariotti +10 more
TL;DR: Using recombinant human monoclonal thyroglobulin antibodies expressed as Fab molecules (TgAb‐Fab), the restriction of Tg epitopes in Hashimoto’s thyroiditis is confirmed.