Thyreoglobulinebepaling goed bruikbaar in de follow-up van schildkliercarcinoompatiënten na thyreoïdectomie, in vergelijking met lichaamsscintigrafie

To determine whether it is reliable to do thyroglobulin measurements during thyroid hormone substitution (Tg ON) alone or whether it is also necessary to do ¹³¹I total body scanning (TBS) and Tg measurements after withdrawal of thyroid hormone substitution (Tg OFF) in the follow-up of patients with differentiated thyroid carcinoma.

Design

Retrospective.

Setting

University Hospital Nijmegen.

Methods

202 Patients (151 females and 51 males, mean age 50,6 years) with differentiated thyroid carcinoma were examined in the period 1970-90. All patients had undergone total thyroidectomy and if necessary ¹³¹I ablation. 27 Patients with Tg antibodies were excluded (13.4). In 175 patients Tg OFF levels were compared with TBS and clinical and radiological data. In 81 of them Tg ON levels were also compared.

Results

Specificity of Tg OFF and Tg ON measurement was 83 and 88. Sensitivity of Tg OFF and Tg ON measurement was 100 and 92. In detecting local residual thyroid tissue Tg OFF was superior to Tg ON. In detecting metastases Tg OFF and Tg ON were both superior to TBS.

Conclusion

In the follow-up of patients with differentiated thyroid carcinoma it is reliable to do Tg measurements during thyroid hormone suppression. When Tg ON is detectable (> 3 pmoll) TBS and Tg OFF measurement and if necessary further investigations have to be performed.