SFEBES2007 Poster Presentations AMEND Young Investigator's Award (21 abstracts)
Clinical impact of thyroglobulin epitope recognition pattern in patients with differentiated thyroid carcinoma and positive thyroglobulin antibodies
Gelsy A Lupoli 2 , Onyebuchi E Okosieme 1 , Carol Evans 1 , Arthur B Parkes 1 , Jean Ruf 1 , Maria R Poggiano 2 , Giovanni Lupoli 2 & John H Lazarus 1
1Centre for Endocrine and Diabetes Sciences, School of Medicine, Cardiff University, Cardiff, United Kingdom; 2Department of Molecular and Clinical Endocrinology and Oncology, University ‘Federico II’, Naples, Italy.
Background: Serum thyroglobulin (Tg) is a useful marker of recurrent or persistent disease in the follow-up of patients with differentiated thyroid carcinoma (DTC); the presence of interfering Tg antibodies (TgAb), even in low concentrations, can lead to a distorted evaluation of this marker. However, TgAb by itself has been shown to be a marker of disease following surgery. TgAb recognition of Tg epitopes differs in pathological and non-pathological states and may thus have prognostic value.
Aim: To determine the epitopes on Tg recognised by TgAb-positive DTC sera and to evaluate whether there is an association between specific TgAb epitope recognition patterns and clinical outcome in patients with DTC.
Methods: All tested sera were TgAb positive. We evaluated TgAb levels and TgAb epitope specificity patterns during the post-surgery follow-up of patients with DTC (n=21) and also in autoimmune thyroid disease (AITD) patients (n=21). Epitope recognition was determined by using 10 Tg monoclonal antibodies (Tg-Mabs) directed against 6 Tg antigenic clusters (I-VI) in competitive enzyme-linked immunosorbent assay (ELISA) reactions with test sera. Tg levels were assessed by immunochemiluminometric assay. We evaluated the disease status of DTC patients, by clinical, biochemical and radiologic examinations.
Results: TgAb levels were comparable in DTC and AITD patients: 1925±299 kUI/l (mean±S.D.) vs 2257±324, respectively (P>0.05). Tg levels were ≤0.5 ng/ml in all DTC patients. TgAb sera from 9 patients with AITD recognized the typical immunodominant clusters I and IV, compared to 7 of DTC patients (P=n.s). Five DTC patients had advanced stage of disease: 2 showed metastatic lymphnodes, 1 a paratracheal mass, 2 local recurrence; none of them had high Tg levels. Four of them showed a distinct Tg epitope pattern involving immunodominant clusters.
Conclusions: We found a similar Tg epitope specificity in both AITD and DTC. Recognition of immunodominant clusters in some patients with DTC maybe associated with a less favourable prognosis.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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