Advances in Diagnosis and Treatment of Differentiated Thyroid Cancer in Patients Showing Thyroglobulin Elevative and Iodine Scintigraphy Negative_Journal of Biomedical Engineering

Authors：

MANingshuai ,  LISuping

Department of Nuclear Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China;

Corresponding author：

LISuping, Email: suping7273@163.com

Keywords：

thyroglobulin; ¹³¹I-whole body scan; differentiated thyroid cancer

DOI：

10.7507/1001-5515.20150129

Video：

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Thyroglobulin (Tg) and radioiodine whole body scan (WBS) have been commonly used in follow-up of patients with differentiated thyroid carcinoma (DTC). Tg is associated with radioiodine uptake in local or distant metastases. In minority of patients, the follow-up scan shows no functioning thyroid tissue, but the serum thyroglobulin is still elevated. Therefore, we review recent developments of diagnosis and treatment of those patients with differentiated thyroid cancer and with thyroglobulin elevation but negative iodine scintigraphy.

Citation： MANingshuai, LISuping. Advances in Diagnosis and Treatment of Differentiated Thyroid Cancer in Patients Showing Thyroglobulin Elevative and Iodine Scintigraphy Negative. Journal of Biomedical Engineering, 2015, 32(3): 707-711. doi: 10.7507/1001-5515.20150129 Copy

1.	SILBERSTEIN E B. The problem of the patient with thyroglobulin elevation but negative Iodine scintigraphy:the TENIS syndrome[J]. Semin Nucl Med, 2011, 41(2):113-120.
2.	戴庆靖, 匡安仁.TgAb对ECLIA和RIA测定Tg影响的对比研究[J].生物医学工程学杂志, 2012, 29(2):242-246.
3.	SONG H J, XUE Y L, QIU Z L, et al. Uncommon metastases from differentiated thyroid carcinoma[J]. Hell J Nucl Med, 2012, 15(3):233-240.
4.	李建芳, 程木华, 许杰华, 等.¹³¹I扫描与断层显像定量分析甲状腺病灶的比较[J].中华核医学与分子影像杂志, 2012, 32(3):222-223.
5.	ADEDAPO K S, VANGU M D. Data on repeated (131)I-WB scans and the incidence of positive Tg and negative (131)I-WBS in DTC patients from a 24 months study[J]. Hell J Nucl Med, 2011, 14(2):131-134.
6.	CHINDRIS A M, DIEHL N N, CROOK J E, et al. Undetectable sensitive serum thyroglobulin (<0.1ng/ml) in 163 patients with follicular cell-derived thyroid cancer:results of rhTSH stimulation and neck ultrasonography and long-term biochemical and clinical follow-up[J]. J Clin Endocrinol Metab, 2012, 97(8):2714-2723.
7.	MIZRACHI A, FEINMESSER R, BACHAR G, et al. Value of ultrasound in detecting central compartment lymph node metastases in differentiated thyroid carcinoma[J]. Eur Arch Otorhinolaryngol, 2013.
8.	PALANISWAMY S S, SUBRAMANYAM P. Diagnostic utility of PETCT in thyroid malignancies:an update[J]. Ann Nucl Med, 2013, 27(8):681-693.
9.	HONG C M, AHN B C, JEONG S Y, et al. Distant metastatic lesions in patients with differentiated thyroid carcinoma. clinical implications of radioiodine and FDG uptake[J]. Nuklearmedizin, 2013, 52(4):121-129.
10.	VURAL G U, AKKAS B E, ERCAKMAK N, et al. Prognostic significance of FDG PET/CT on the follow-up of patients of differentiated thyroid carcinoma with negative ¹³¹I whole-body scan and elevated thyroglobulin levels:correlation with clinical and histopathologic characteristics and long-term follow-up data[J]. Clin Nucl Med, 2012, 37(10):953-959.
11.	OZKAN E, ARAS G, KUCUK N O. Correlation of ¹⁸F-FDG PET/CT findings with histopathological results in differentiated thyroid cancer patients who have increased thyroglobulin or antithyroglobulin antibody levels and negative ¹³¹I whole-body scan results[J]. Clin Nucl Med, 2013, 38(5):326-331.
12.	SCHLVTER B, BOHUSLAVIZKI K H, BEYER W, et al. Impact of FDG PET on patients with differentiated thyroid cancer who present with elevated thyroglobulin and negative ¹³¹I scan[J]. J Nucl Med, 2001, 42(1):71-76.
13.	NA S J, YOO IER, O J H, et al. Diagnostic accuracy of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in differentiated thyroid cancer patients with elevated thyroglobulin and negative (131)I whole body scan:evaluation by thyroglobulin level[J]. Ann Nucl Med, 2012, 26(1):26-34.
14.	WANG W, LARSON S M, TUTTLE R M, et al. Resistance of ^[18f]-fluorodeoxyglucose-avid metastatic thyroid cancer lesions to treatment with high-dose radioactive Iodine[J]. Thyroid, 2001, 11(12):1169-1175.
15.	BANNAS P, DERLIN T, GROTH M, et al. Can (18)F-FDG-PET/CT be generally recommended in patients with differentiated thyroid carcinoma and elevated thyroglobulin levels but negative I-131 whole body scan?[J]. Ann Nucl Med, 2012, 26(1):77-85.
16.	CABRERA M M, PASAMONTES P J, CARRERAS D J, et al. Diagnostic accuracy of ¹⁸F-FDG PET in residual or recurrent differentiated thyroid carcinoma with high thyroglobulin and negative 131-I whole-body scan[J].Rev Esp Med Nucl, 2007, 26(5):263-269.
17.	鹿存涛, 曹苏生, 王伟, 等.促甲状腺激素水平对~(18)F-FDG PET/CT诊断分化型甲状腺癌失分化后复发及转移灶的影响[J].中国肿瘤外科杂志, 2013, 5(2):79-81.
18.	林红利.基于CT影像的肺结节病变计算机辅助诊断关键技术研究[D].长沙:中南大学, 2011.
19.	BASU S, ABHYANKAR A, ASOPA R, et al. A logical levothyroxine dose individualization:optimization approach at discharge from radioiodine therapy ward and during follow-up in patients of differentiated thyroid carcinoma:balancing the risk based strategy and the practical issues and challenges:experience and views of a large volume referral centre in India[J]. Indian J Nucl Med, 2013, 28(1):1-4.
20.	SCHLUMBERGER M, ARCANGIOLI O, PIEKARSKI J D, et al. Detection and treatment of lung metastases of differentiated thyroid carcinoma in patients with normal chest X-rays[J]. J Nucl Med, 1988, 29(11):1790-1794.
21.	SINHA P, CONRAD G R, WEST H C. Response of thyroglobulin to radioiodine therapy in thyroglobulin-elevated negative iodine scintigraphy (TENIS) syndrome[J]. Anticancer Res, 2011, 31(6):2109-2112.
22.	GONZÁLEZ C, AULINAS A, COLOM C, et al. Thyroglobulin as early prognostic marker to predict remission at 18-24 months in differentiated thyroid carcinoma[J]. Clin Endocrinol (Oxf), 2013.
23.	CHAO M. Management of differentiated thyroid cancer with rising thyroglobulin and negative diagnostic radioiodine whole body scan[J]. Clin Oncol (R Coll Radiol), 2010, 22(6):438-447.
24.	DOBRENIC M, HUIC D, ZUVIC M, et al. Usefulness of low iodine diet in managing patients with differentiated thyroid cancer-initial results[J]. Radiol Oncol, 2011, 45(3):189-195.
25.	关海霞, 陆汉魁.重组人促甲状腺激素在甲状腺疾病诊治中的应用[J].中华核医学与分子影像杂志, 2012, 32(4):311-314.
26.	LI W, AIN K B. Human sodium-iodide symporter (hNIS) gene expression is inhibited by a trans-active transcriptional repressor, NIS-repressor, containing PARP-1 in thyroid cancer cells[J]. Endocr Relat Cancer, 2010, 17(2):383-398.
27.	AL-HUMADI H, ZARROS A, AL-SAIGH R, et al. Genetic basis and gene therapy trials for thyroid cancer[J]. Cancer Genomics Proteomics, 2010, 7(1):31-49.
28.	VERBURG F A, MÄDER U, TANASE K, et al. Life expectancy is reduced in differentiated thyroid cancer patients≥45 years old with extensive local tumor invasion, lateral lymph node, or distant metastases at diagnosis and normal in all other DTC patients[J]. J Clin Endocrinol Metab, 2013, 98(1):172-180.

1. SILBERSTEIN E B. The problem of the patient with thyroglobulin elevation but negative Iodine scintigraphy:the TENIS syndrome[J]. Semin Nucl Med, 2011, 41(2):113-120.
2. 戴庆靖, 匡安仁.TgAb对ECLIA和RIA测定Tg影响的对比研究[J].生物医学工程学杂志, 2012, 29(2):242-246.
3. SONG H J, XUE Y L, QIU Z L, et al. Uncommon metastases from differentiated thyroid carcinoma[J]. Hell J Nucl Med, 2012, 15(3):233-240.
4. 李建芳, 程木华, 许杰华, 等.¹³¹I扫描与断层显像定量分析甲状腺病灶的比较[J].中华核医学与分子影像杂志, 2012, 32(3):222-223.
5. ADEDAPO K S, VANGU M D. Data on repeated (131)I-WB scans and the incidence of positive Tg and negative (131)I-WBS in DTC patients from a 24 months study[J]. Hell J Nucl Med, 2011, 14(2):131-134.
6. CHINDRIS A M, DIEHL N N, CROOK J E, et al. Undetectable sensitive serum thyroglobulin (<0.1ng/ml) in 163 patients with follicular cell-derived thyroid cancer:results of rhTSH stimulation and neck ultrasonography and long-term biochemical and clinical follow-up[J]. J Clin Endocrinol Metab, 2012, 97(8):2714-2723.
7. MIZRACHI A, FEINMESSER R, BACHAR G, et al. Value of ultrasound in detecting central compartment lymph node metastases in differentiated thyroid carcinoma[J]. Eur Arch Otorhinolaryngol, 2013.
8. PALANISWAMY S S, SUBRAMANYAM P. Diagnostic utility of PETCT in thyroid malignancies:an update[J]. Ann Nucl Med, 2013, 27(8):681-693.
9. HONG C M, AHN B C, JEONG S Y, et al. Distant metastatic lesions in patients with differentiated thyroid carcinoma. clinical implications of radioiodine and FDG uptake[J]. Nuklearmedizin, 2013, 52(4):121-129.
10. VURAL G U, AKKAS B E, ERCAKMAK N, et al. Prognostic significance of FDG PET/CT on the follow-up of patients of differentiated thyroid carcinoma with negative ¹³¹I whole-body scan and elevated thyroglobulin levels:correlation with clinical and histopathologic characteristics and long-term follow-up data[J]. Clin Nucl Med, 2012, 37(10):953-959.
11. OZKAN E, ARAS G, KUCUK N O. Correlation of ¹⁸F-FDG PET/CT findings with histopathological results in differentiated thyroid cancer patients who have increased thyroglobulin or antithyroglobulin antibody levels and negative ¹³¹I whole-body scan results[J]. Clin Nucl Med, 2013, 38(5):326-331.
12. SCHLVTER B, BOHUSLAVIZKI K H, BEYER W, et al. Impact of FDG PET on patients with differentiated thyroid cancer who present with elevated thyroglobulin and negative ¹³¹I scan[J]. J Nucl Med, 2001, 42(1):71-76.
13. NA S J, YOO IER, O J H, et al. Diagnostic accuracy of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in differentiated thyroid cancer patients with elevated thyroglobulin and negative (131)I whole body scan:evaluation by thyroglobulin level[J]. Ann Nucl Med, 2012, 26(1):26-34.
14. WANG W, LARSON S M, TUTTLE R M, et al. Resistance of ^[18f]-fluorodeoxyglucose-avid metastatic thyroid cancer lesions to treatment with high-dose radioactive Iodine[J]. Thyroid, 2001, 11(12):1169-1175.
15. BANNAS P, DERLIN T, GROTH M, et al. Can (18)F-FDG-PET/CT be generally recommended in patients with differentiated thyroid carcinoma and elevated thyroglobulin levels but negative I-131 whole body scan?[J]. Ann Nucl Med, 2012, 26(1):77-85.
16. CABRERA M M, PASAMONTES P J, CARRERAS D J, et al. Diagnostic accuracy of ¹⁸F-FDG PET in residual or recurrent differentiated thyroid carcinoma with high thyroglobulin and negative 131-I whole-body scan[J].Rev Esp Med Nucl, 2007, 26(5):263-269.
17. 鹿存涛, 曹苏生, 王伟, 等.促甲状腺激素水平对~(18)F-FDG PET/CT诊断分化型甲状腺癌失分化后复发及转移灶的影响[J].中国肿瘤外科杂志, 2013, 5(2):79-81.
18. 林红利.基于CT影像的肺结节病变计算机辅助诊断关键技术研究[D].长沙:中南大学, 2011.
19. BASU S, ABHYANKAR A, ASOPA R, et al. A logical levothyroxine dose individualization:optimization approach at discharge from radioiodine therapy ward and during follow-up in patients of differentiated thyroid carcinoma:balancing the risk based strategy and the practical issues and challenges:experience and views of a large volume referral centre in India[J]. Indian J Nucl Med, 2013, 28(1):1-4.
20. SCHLUMBERGER M, ARCANGIOLI O, PIEKARSKI J D, et al. Detection and treatment of lung metastases of differentiated thyroid carcinoma in patients with normal chest X-rays[J]. J Nucl Med, 1988, 29(11):1790-1794.
21. SINHA P, CONRAD G R, WEST H C. Response of thyroglobulin to radioiodine therapy in thyroglobulin-elevated negative iodine scintigraphy (TENIS) syndrome[J]. Anticancer Res, 2011, 31(6):2109-2112.
22. GONZÁLEZ C, AULINAS A, COLOM C, et al. Thyroglobulin as early prognostic marker to predict remission at 18-24 months in differentiated thyroid carcinoma[J]. Clin Endocrinol (Oxf), 2013.
23. CHAO M. Management of differentiated thyroid cancer with rising thyroglobulin and negative diagnostic radioiodine whole body scan[J]. Clin Oncol (R Coll Radiol), 2010, 22(6):438-447.
24. DOBRENIC M, HUIC D, ZUVIC M, et al. Usefulness of low iodine diet in managing patients with differentiated thyroid cancer-initial results[J]. Radiol Oncol, 2011, 45(3):189-195.
25. 关海霞, 陆汉魁.重组人促甲状腺激素在甲状腺疾病诊治中的应用[J].中华核医学与分子影像杂志, 2012, 32(4):311-314.
26. LI W, AIN K B. Human sodium-iodide symporter (hNIS) gene expression is inhibited by a trans-active transcriptional repressor, NIS-repressor, containing PARP-1 in thyroid cancer cells[J]. Endocr Relat Cancer, 2010, 17(2):383-398.
27. AL-HUMADI H, ZARROS A, AL-SAIGH R, et al. Genetic basis and gene therapy trials for thyroid cancer[J]. Cancer Genomics Proteomics, 2010, 7(1):31-49.
28. VERBURG F A, MÄDER U, TANASE K, et al. Life expectancy is reduced in differentiated thyroid cancer patients≥45 years old with extensive local tumor invasion, lateral lymph node, or distant metastases at diagnosis and normal in all other DTC patients[J]. J Clin Endocrinol Metab, 2013, 98(1):172-180.

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