ECE2017 Eposter Presentations: Thyroid Thyroid (non-cancer) (260 abstracts)
BRAFV600E status and Stimulated Thyroglobulin at ablation time increase prognostic value of American Thyroid Association (ATA) classification systems for persistent disease in Differentiated Thyroid Carcinoma (DTC)
Andrea Repaci 1 , Valentina Vicennati 1 , Alexandro Paccapelo 1 , Nicola Salituro 1 , Ottavio Cavicchi 2 , Fabio Monari 3 , Giovanni Tallini 5 , Elisa Gruppioni 4 , Annalisa Altimari 4 , Michelangelo Fiorentino 4 & Uberto Pagotto 1
1Endocrinology Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna, Italy; 2Otolaringology Unit, S. Orsola-Malpighi Hospital, Bologna, Italy; 3Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, S. Orsola-Malpighi Hospital, Alma Mater University of Bologna, S. Orsola-Malpighi, Bologna, Italy; 4Laboratory of Oncologic Molecular Pathology, S.Orsola-Malpighi Hospital, Bologna, Italy; 5Anatomic Pathology-Molecular Diagnostic Unit AUSL of Bologna,Department of Medicine (DIMES), Bologna, Italy.
Background: Stimulated Thyroglobulin levels measured at the time of remnant ablation (Htg-A) and BRAFV600E mutation were shown to have prognostic value in predicting persistent disease in DTC. The aim of this study was to evaluate the prognostic role of Htg-A combined with BRAFV600E status in association with revised American Thyroid Association (ATA) risk stratification.
Patients and methods: 620 patients treated for a DTC were included in this study with median follow-up duration of 6.1 year. All patients were submitted to a total thyroidectomy, followed by radioiodine ablation. Patients with positive antibodies anti-Tg were excluded. The predictive value of Htg-A was calculated by receiver operating characteristic curve analysis. Cox proportional hazard regression modeling, including BRAF status, Htg-A and ATA classification system, was assessed to evaluate existing persistent disease risk.
Results: BRAF status and Htg-A levels together improve ATA risk classification in all categories. In particular in Low risk ATA only BRAFV600E+Htg-A>8.9 ng/ml was associated with persistent disease (P=0.001 HR 60.2 CI 95% 5.28–687. In Intermediate ATA risk BRAFwt + Htg-A>8.9 ng/ml was associated with persistent disease (P=0.029 HR 2.71 CI 95% 1.106–6.670) and BRAFV600E+Htg>8.9 ng/ml was associated with persistent disease (P=0.000 HR 5.001 CI 95% 2.318–10.790). In High risk ATA BRAFV600E+Htg-A<8.9 ng/ml was associated with persistent disease (P=0.042 HR 5.963 CI 95% 1.069–33.255) and BRAFV600E+Htg-A>8.9 ng/ml was associated with persistent disease (P=0.002 HR 11.564 CI 95% 2.543–52.576).
Conclusion: BRAF status and Stimulated Thyroglobulin levels at ablation time improve the ATA risk stratification, so also Htg-A could be included in ATA risk classification.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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