Endocrine Abstracts

Introduction

The measurement of serum thyroglobulin (Tg), a glycoprotein produced exclusively by follicular thyroid cells, is an important tumour marker used in the follow-up of patients with differentiated thyroid carcinoma (DTC) and residual or recurrent disease. However, its role as a screening tool before thyroid surgery is not yet defined, as benign conditions can result in its increase.

Objective

The aim of this study was to retrospectively assess whether there is a relationship between high preoperative serum Tg levels and thyroid carcinoma patients undergoing thyroid surgery.

Material and methods

Retrospective review of the medical records of patients who underwent thyroid surgery in our Institution for nodular goitre, whose serum Tg levels were assessed preoperatively.

Results and conclusions

Thirty-three patients (22 female/11 male) were identified, with a mean age of 51.7 ± 15 years. Twenty-seven (81.8%) underwent total thyroidectomy and six (18.2%), lobectomy alone. High levels of serum Tg were identified in 23 patients: 13 patients (56.5%) among 23 with malignant histopathological features and in 10 patients (43.5%) among 13 with benign histology (P = 0.143). Among four patients with higher Tg levels (Tg > 1000 ng/ml), only one had a malignant histology. Preoperative elevated levels of serum Tg showed a 56.5% sensitivity, 15.4% specificity, a positive predictive value of 54.2% and a negative predictive value of 16.7% in detecting DTC. In conclusion, there was no statistically significant association between preoperative serum Tg levels and the diagnosis of thyroid carcinoma. These results confirm the current recommendations in the management of patients with nodular thyroid disease.