Thyroglobulin Test at 3 Weeks after Surgery in Well-Differentiated Thyroid Cancer and its Predictive Value: The Role of Endocrine–Metabolic Status

Abstract

Aim & methods: The present pilot study included 50 differentiated thyroid cancer (DTC) patients (mean age: 45.8 ± 1.8 years, range: 18–73 years) who were followed after surgery for in average 30.0 ± 2.6 months. All patients were subdivided into two groups as having either <2 ng/ml or ≥2 ng/ml blood thyroglobulin level 3 weeks after the operation (3-WTT). Results: Subsequent tumor progression was revealed more often in patients with higher thyroglobulinemia (≥2 ng/ml) in both low- and high-risk DTC groups. Patients with high-risk DTC and 3-week thyroglobulin levels ≥2 ng/ml were more likely to have a higher pre-surgical thyrotropin (TSH) levels. On the contrary, patients with low-risk DTC and 3-week thyroglobulin level ≥2 ng/ml demonstrated tendency to higher preoperative serum insulin levels and higher BMI. Conclusion: These differential findings could suggest that, whereas maximal suppression of TSH is reasonable in high-risk DTC patients, in low-risk DTC patients, for whom this is not justified, a moderate TSH suppression supplemented by multivalent drugs, such as antidiabetic biguanide metformin, could be advised.

Keywords:

• BMI
• course of the disease
• early postsurgical testing
• glycemia
• high and low risk
• insulinemia
• progression
• serum thyroglobulin
• TSH
• well-differentiated thyroid cancer

Acknowledgements

Useful discussions with Dr. Alexey Golubev (Research Institute of Experimental Medicine, St Petersburg) are highly appreciated.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties. No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.