Serum thyroglobulin is a poor diagnostic biomarker of malignancy in follicular and Ḧurthle-cell neoplasms of the thyroid

Insoo Suh, Menno R. Vriens, Marlon A. Guerrero, Ann Griffin, Wen T. Shen, Quan Yang Duh, Orlo H. Clark, Electron Kebebew

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Background: Serum thyroglobulin (Tg) is the most accurate biomarker for thyroid cancer recurrence. However, some clinicians measure preoperative Tg as a diagnostic cancer marker despite lack of supporting evidence. We examined whether Tg accurately predicts malignancy in follicular or Hürthle-cell neoplasms. Methods: We reviewed 366 patients who underwent thyroidectomies for follicular/Hürthle-cell neoplasms. We compared Tg in malignant versus benign tumors by univariate and receiver-operator characteristic analyses. We also examined several Tg-derived indices that normalized Tg to known confounding factors including nodule size, thyroid function, and type of Tg assay. Results: Thirty-nine patients met inclusion criteria for analysis. There were no differences between malignant (n = 16) and benign (n = 23) lesions in Tg or any of the normalized indexes. Receiver-operator characteristic analysis revealed an area under the curve of .59. Lesions with Tg levels greater than 500 μg/L had a positive predictive value of .75. Conclusions: Tg has poor accuracy for predicting malignancy in follicular or Hürthle-cell thyroid neoplasms.

Original languageEnglish (US)
Pages (from-to)41-46
Number of pages6
JournalAmerican journal of surgery
Volume200
Issue number1
DOIs
StatePublished - Jul 1 2010
Externally publishedYes

Keywords

  • Biological markers
  • Follicular thyroid neoplasms
  • Hürthle-cell thyroid neoplasms
  • Thyroglobulin
  • Thyroid nodules

ASJC Scopus subject areas

  • Surgery

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