Factors influencing the basal and recombinant human thyrotropin-stimulated serum thyroglobulin in patients with metastatic thyroid carcinoma Journal Article


Authors: Robbins, R. J.; Srivastava, S.; Shaha, A.; Ghossein, R.; Larson, S. M.; Fleisher, M.; Tuttle, R. M.
Article Title: Factors influencing the basal and recombinant human thyrotropin-stimulated serum thyroglobulin in patients with metastatic thyroid carcinoma
Abstract: The serum thyroglobulin (Tg) level is the most sensitive marker for detecting residual thyroid carcinoma. We hypothesized that the basal and TSH-stimulaied Tg levels in patients with metastatic thyroid carcinoma would reflect tumor volume, histological subtype, and location of metastatic lesions. A retrospective review of 417 thyroid cancer survivors undergoing evaluation for residual disease with the assistance of recombinant human TSH (rhTSH) was performed. In 169 patients with metastatic disease, we found that the basal Tg level directly correlated with the number of lesions, and that it was highest in patients with follicular and lowest in those with papillary thyroid carcinoma. The basal Tg level was highest in patients with bone metastases and lowest in those with cervical metastases. The fold increase in the serum Tg after rhTSH treatment was highest in papillary thyroid carcinoma and lowest in Hurthle cell carcinoma. The fold increase in Tg was not influenced by tumor volume or by the site of metastatic lesions. Multivariate analysis showed multiple interactions between factors, but did not identify one factor that significantly influenced basal Tg or fold increase. We conclude that the location and volume of metastases influence basal Tg, but not its responsiveness to rhTSH, whereas the histological type of carcinoma influences both basal Tg and responsiveness to rhTSH.
Keywords: adult; cancer survival; controlled study; human tissue; aged; middle aged; retrospective studies; major clinical study; review; cancer localization; bone metastasis; cancer patient; metastasis; tumor volume; carcinoma, papillary; retrospective study; histology; oncocytoma; adenoma, oxyphilic; correlation analysis; iodine radioisotopes; minimal residual disease; neoplasm, residual; recombinant proteins; carcinoma; protein induction; multivariate analysis; thyroid carcinoma; thyroid neoplasms; papillary carcinoma; thyroglobulin; thyroglobulin blood level; adenocarcinoma, follicular; recombinant thyrotropin; uterine cervix; thyrotropin; follicular carcinoma; humans; human; male; female; priority journal
Journal Title: Journal of Clinical Endocrinology and Metabolism
Volume: 89
Issue: 12
ISSN: 0021-972X
Publisher: Oxford University Press  
Date Published: 2004-12-01
Start Page: 6010
End Page: 6016
Language: English
DOI: 10.1210/jc.2003-031573
PROVIDER: scopus
PUBMED: 15579752
DOI/URL:
Notes: J. Clin. Endocrinol. Metab. -- Cited By (since 1996):28 -- Export Date: 16 June 2014 -- CODEN: JCEMA -- Source: Scopus
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MSK Authors
  1. Ronald A Ghossein
    483 Ghossein
  2. Ashok R Shaha
    698 Shaha
  3. Robert M Tuttle
    482 Tuttle
  4. Richard J Robbins
    54 Robbins
  5. Steven M Larson
    959 Larson
  6. Martin Fleisher
    312 Fleisher