Research progress of thyroglobulin in evaluating lymph node metastasis of differentiated thyroid carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAN Xiao , YU Qing’an , GAO Xu ,  DAI Wenjie

Department of Thyroid Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, P. R. China;

Corresponding author：

DAI Wenjie, Email: davidhmu@163.com

Keywords：

differentiated thyroid carcinoma; thyroglobulin; lymph node metastasis; assessment; follow-up

DOI：

10.7507/1007-9424.202102011

Video：

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Objective To explore the significance of thyroglobulin in the evaluation of lymph node metastasis during the treatment and follow-up of differentiated thyroid carcinoma.Method The literatures about thyroid globulin evaluation of lymph node metastasis of differentiated thyroid carcinoma were collected through online database and summarized.Results The determination of thyroglobulin played an important role in the perioperative evaluation of lymph node metastasis in patients with differentiated thyroid carcinoma, the guidance of postoperative radiotherapy for metastasis, and the monitoring of recurrence and metastasis, and thyroglobulin combined with imaging examination could improve its evaluation efficiency.Conclusions Thyroglobulin is an important marker for the evaluation of lymph node metastasis in the treatment and follow-up of differentiated thyroid carcinoma. Combination between thyroglobulin and imaging examination or other laboratory indicators to comprehensively explore its diagnostic threshold is a new idea, that can improve its value in the evaluation of lymph node metastasis.

Citation： YAN Xiao, YU Qing’an, GAO Xu, DAI Wenjie. Research progress of thyroglobulin in evaluating lymph node metastasis of differentiated thyroid carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(1): 124-129. doi: 10.7507/1007-9424.202102011 Copy

1.	Kilfoy BA, Zheng T, Holford TR, et al. International patterns and trends in thyroid cancer incidence, 1973-2002. Cancer Causes Control, 2009, 20(5): 525-531.
2.	Tam S, Boonsripitayanon M, Amit M, et al. Survival in differentiated thyroid cancer: comparing the AJCC cancer staging seventh and eighth editions. Thyroid, 2018, 28(10): 1301-1310.
3.	Noguchi S, Noguchi A, Murakami N. Papillary carcinoma of the thyroid. Ⅰ. Developing pattern of metastasis. Cancer, 1970, 26(5): 1053-1060.
4.	Adam MA, Pura J, Goffredo P, et al. Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer. J Clin Oncol, 2015, 33(21): 2370-2375.
5.	Baldini E, Sorrenti S, Di Gioia C, et al. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology? BMC Clin Pathol, 2013, 13: 7.
6.	Kim DW, Jeon SJ, Kim CG. Usefulness of thyroglobulin measurement in needle washouts of fine-needle aspiration biopsy for the diagnosis of cervical lymph node metastases from papillary thyroid cancer before thyroidectomy. Endocrine, 2012, 42(2): 399-403.
7.	Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid, 2016, 26(1): 1-133.
8.	中华医学会内分泌学分会, 中华医学会外科学分会, 中国抗癌协会头颈肿瘤专业委员会, 等. 甲状腺结节和分化型甲状腺癌诊治指南. 中国肿瘤临床, 2012, 39(17): 1249-1272.
9.	Patell R, Mikhael A, Tabet M, et al. Assessing the utility of preoperative serum thyroglobulin in differentiated thyroid cancer: a retrospective cohort study. Endocrine, 2018, 61(3): 506-510.
10.	Kim H, Park SY, Choe JH, et al. Preoperative serum thyroglobulin and its correlation with the burden and extent of differentiated thyroid cancer. Cancers (Basel), 2020, 12(3): 625.
11.	Huang Z, Song M, Wang S, et al. Preoperative serum thyroglobulin is a risk factor of skip metastasis in papillary thyroid carcinoma. Ann Transl Med, 2020, 8(6): 389.
12.	周乐, 张广, 张大奇, 等. 细针穿刺活检及洗脱液检测在甲状腺癌颈淋巴结清扫决策中的应用研究. 中国实用外科杂志, 2017, 37(9): 1002-1006.
13.	Xu Y, Wu D, Wu W, et al. Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer: a systematic review and network meta-analysis. Medicine (Baltimore), 2019, 98(45): e17859.
14.	Zhu XH, Zhou JN, Qian YY, et al. Diagnostic values of thyroglobulin in lymph node fine-needle aspiration washout: a systematic review and meta-analysis diagnostic values of FNA-Tg. Endocr J, 2020, 67(2): 113-123.
15.	Sakamoto K, Imanishi Y, Tomita T, et al. Usefulness and limitation of thyroglobulin measurement in fine needle aspirates (FNA-Tg) for diagnosis of neck lymph node metastasis from thyroid carcinoma. Nihon Jibiinkoka Gakkai Kaiho, 2016, 119(5): 721-726.
16.	Jo K, Kim MH, Lim Y, et al. Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody. Eur J Endocrinol, 2015, 173(4): 489-497.
17.	Liu X, Ouyang D, Li H, et al. Papillary thyroid cancer: dual-energy spectral CT quantitative parameters for preoperative diagnosis of metastasis to the cervical lymph nodes. Radiology, 2015, 275(1): 167-176.
18.	Shin HJ, Lee HS, Kim EK, et al. A study on serum antithyroglobulin antibodies interference in thyroglobulin measurement in fine-needle aspiration for diagnosing lymph node metastasis in postoperative patients. PLoS One, 2015, 10(6): e0131096.
19.	Wang J, Jiang X, Xiao G, et al. Excellent diagnostic performance of FNA-Tg in detecting lymph nodes metastases from papillary thyroid cancer. Future Oncol, 2020, 16(33): 2735-2746.
20.	李想, 黄韬, 刁畅, 等. 甲状腺球蛋白抗体和甲状腺过氧化物酶抗体状态对分化型甲状腺癌患者中央区淋巴结影响的多中心临床研究. 中国普外基础与临床杂志, 2020, 27(11): 1392-1396.
21.	Hong CM, Jeong JH, Son SH, et al. Serum thyroglobulin elevation after needle aspiration of the lymph nodes: the predictive value for detecting metastasis in papillary thyroid cancer patients—a pilot study. Medicine (Baltimore), 2019, 98(31): e16461.
22.	Wu X, Gu H, Gao Y, et al. Clinical outcomes and prognostic factors of radioiodine ablation therapy for lymph node metastases from papillary thyroid carcinoma. Nucl Med Commun, 2018, 39(1): 22-27.
23.	赵连春, 刘光霞, 陈芳, 等. 血清甲状腺球蛋白在分化型甲状腺癌术后转移的诊断预测效能分析. 热带医学杂志, 2020, 20(12): 1569-1572.
24.	高刘艳, 李素平. 甲状腺球蛋白和甲状腺球蛋白抗体在分化型甲状腺癌诊治中的价值. 国际放射医学核医学杂志, 2020, 44(3): 196-201.
25.	Ronga G, Filesi M, Ventroni G, et al. Value of the first serum thyroglobulin level after total thyroidectomy for the diagnosis of metastases from differentiated thyroid carcinoma. Eur J Nucl Med, 1999, 26(11): 1448-1452.
26.	Makarewicz J, Adamczewski Z, Rutkowski A, et al. An evaluation of the value of first thyroglobulin determination in the diagnostics of metastases immediately following differentiated thyroid carcinoma surgery. Endokrynol Pol, 2006, 57(4): 370-373.
27.	Demir F, Şimşek FS, Ansal Balcı T. The role of pre-ablative stimulated thyroglobulin and thyroglobulin/thyroid-stimulating hormone ratio for predicting metastasis in thyroid cancer. Mol Imaging Radionucl Ther, 2019, 28(1): 21-26.
28.	Prabhu M, Samson S, Reddy A, et al. Role of preablative stimulated thyroglobulin in prediction of nodal and distant metastasis on iodine whole-body scan. Indian J Nucl Med, 2018, 33(2): 93-98.
29.	陈鹏, 宋长祥, 陆武, 等. 术后刺激性甲状腺球蛋白水平预测分化型甲状腺癌功能性转移灶的价值. 中国医学影像学杂志, 2017, 25(6): 422-424, 429.
30.	王芳, 王越, 刁宏翠, 等. 分化型甲状腺癌术后再次 ¹³¹Ⅰ治疗前 sTg 与 sTg/sup-Tg 对淋巴结转移的预测价值. 现代肿瘤医学, 2020, 28(14): 2417-2421.
31.	Park EK, Chung JK, Lim IH, et al. Recurrent/metastatic thyroid carcinomas false negative for serum thyroglobulin but positive by posttherapy I-131 whole body scans. Eur J Nucl Med Mol Imaging, 2009, 36(2): 172-179.
32.	Campennì A, Giovanella L, Pignata SA, et al. Undetectable or low (< 1 ng/mL) postsurgical thyroglobulin values do not rule out metastases in early stage differentiated thyroid cancer patients. Oncotarget, 2018, 9(25): 17491-17500.
33.	Silberstein EB. The problem of the patient with thyroglobulin elevation but negative iodine scintigraphy: the TENIS syndrome. Semin Nucl Med, 2011, 41(2): 113-120.
34.	Song HJ, Xue YL, Qiu ZL, et al. Uncommon metastases from differentiated thyroid carcinoma. Hell J Nucl Med, 2012, 15(3): 233-240.
35.	夏亮, 陆涤宇, 周俊, 等. ¹³¹I-SPECT/CT 多模态显像联合超声及血清 Tg 对分化型甲状腺癌颈部淋巴结转移的诊断价值. 肿瘤学杂志, 2017, 23(4): 278-281.
36.	Spanu A, Nuvoli S, Marongiu A, et al. Neck lymph node metastasis detection in patients with differentiated thyroid carcinoma (DTC) in long-term follow-up: a ¹³¹I-SPECT/CT study. BMC Cancer, 2020, 20(1): 239.
37.	范志娜, 吴刚, 袁建军. 超声联合血清 Tg、SPECT/CT 诊断分化型甲状腺癌术后颈部淋巴结转移. 中国医学影像技术, 2014, 30(3): 362-365.
38.	张瑞坚, 刘立衡, 刘巧爱, 等. 颈部超声联合甲状腺球蛋白检查对分化性甲状腺癌术后复发诊断的临床价值. 中国现代普通外科进展, 2019, 22(7): 515-517.
39.	Moslehi M, Assadi M. Contribution of ultrasound examination in the detection of neck recurrence in low-risk differentiated thyroid carcinoma patients at first follow-up visits. Nucl Med Rev Cent East Eur, 2014, 17(1): 3-6.
40.	Zhao T, Liang J, Li T, et al. Value of serial preablative thyroglobulin measurements: can we address the impact of thyroid remnants? Nucl Med Commun, 2016, 37(6): 632-639.
41.	赵腾, 梁军, 李田军, 等. 分化型甲状腺癌 ¹³¹I 治疗前刺激性 Tg 动态变化与远处转移的关系. 中国医学科学院学报, 2015, 37(3): 315-319.
42.	Rowe ME, Osorio M, Likhterov I, et al. Evaluation of ultrasound reporting for thyroid cancer diagnosis and surveillance. Head Neck, 2017, 39(9): 1756-1760.
43.	Ritter A, Mizrachi A, Bachar G, et al. Detecting recurrence following lobectomy for thyroid cancer: role of thyroglobulin and thyroglobulin antibodies. J Clin Endocrinol Metab, 2020, 105(6): dgaa152.
44.	魏伟军, 沈晨天, 宋红俊, 等. 超敏甲状腺球蛋白测定在分化型甲状腺癌随访中的应用. 中华核医学与分子影像杂志, 2016, 36(5): 474-478.
45.	何凯骅, 章斌, 陈志强, 等. 血清 sTg 和 TgAb 水平监测甲状腺乳头状癌患者低剂量碘-131 疗效的研究. 现代检验医学杂志, 2018, 33(6): 142-145.
46.	冯会娟, 欧阳伟, 孙云钢, 等. 甲状腺球蛋白水平与分化型甲状腺癌转移灶的关系. 广东医学, 2014, 35(6): 878-880, 881.
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1. Kilfoy BA, Zheng T, Holford TR, et al. International patterns and trends in thyroid cancer incidence, 1973-2002. Cancer Causes Control, 2009, 20(5): 525-531.
2. Tam S, Boonsripitayanon M, Amit M, et al. Survival in differentiated thyroid cancer: comparing the AJCC cancer staging seventh and eighth editions. Thyroid, 2018, 28(10): 1301-1310.
3. Noguchi S, Noguchi A, Murakami N. Papillary carcinoma of the thyroid. Ⅰ. Developing pattern of metastasis. Cancer, 1970, 26(5): 1053-1060.
4. Adam MA, Pura J, Goffredo P, et al. Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer. J Clin Oncol, 2015, 33(21): 2370-2375.
5. Baldini E, Sorrenti S, Di Gioia C, et al. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology? BMC Clin Pathol, 2013, 13: 7.
6. Kim DW, Jeon SJ, Kim CG. Usefulness of thyroglobulin measurement in needle washouts of fine-needle aspiration biopsy for the diagnosis of cervical lymph node metastases from papillary thyroid cancer before thyroidectomy. Endocrine, 2012, 42(2): 399-403.
7. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid, 2016, 26(1): 1-133.
8. 中华医学会内分泌学分会, 中华医学会外科学分会, 中国抗癌协会头颈肿瘤专业委员会, 等. 甲状腺结节和分化型甲状腺癌诊治指南. 中国肿瘤临床, 2012, 39(17): 1249-1272.
9. Patell R, Mikhael A, Tabet M, et al. Assessing the utility of preoperative serum thyroglobulin in differentiated thyroid cancer: a retrospective cohort study. Endocrine, 2018, 61(3): 506-510.
10. Kim H, Park SY, Choe JH, et al. Preoperative serum thyroglobulin and its correlation with the burden and extent of differentiated thyroid cancer. Cancers (Basel), 2020, 12(3): 625.
11. Huang Z, Song M, Wang S, et al. Preoperative serum thyroglobulin is a risk factor of skip metastasis in papillary thyroid carcinoma. Ann Transl Med, 2020, 8(6): 389.
12. 周乐, 张广, 张大奇, 等. 细针穿刺活检及洗脱液检测在甲状腺癌颈淋巴结清扫决策中的应用研究. 中国实用外科杂志, 2017, 37(9): 1002-1006.
13. Xu Y, Wu D, Wu W, et al. Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer: a systematic review and network meta-analysis. Medicine (Baltimore), 2019, 98(45): e17859.
14. Zhu XH, Zhou JN, Qian YY, et al. Diagnostic values of thyroglobulin in lymph node fine-needle aspiration washout: a systematic review and meta-analysis diagnostic values of FNA-Tg. Endocr J, 2020, 67(2): 113-123.
15. Sakamoto K, Imanishi Y, Tomita T, et al. Usefulness and limitation of thyroglobulin measurement in fine needle aspirates (FNA-Tg) for diagnosis of neck lymph node metastasis from thyroid carcinoma. Nihon Jibiinkoka Gakkai Kaiho, 2016, 119(5): 721-726.
16. Jo K, Kim MH, Lim Y, et al. Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody. Eur J Endocrinol, 2015, 173(4): 489-497.
17. Liu X, Ouyang D, Li H, et al. Papillary thyroid cancer: dual-energy spectral CT quantitative parameters for preoperative diagnosis of metastasis to the cervical lymph nodes. Radiology, 2015, 275(1): 167-176.
18. Shin HJ, Lee HS, Kim EK, et al. A study on serum antithyroglobulin antibodies interference in thyroglobulin measurement in fine-needle aspiration for diagnosing lymph node metastasis in postoperative patients. PLoS One, 2015, 10(6): e0131096.
19. Wang J, Jiang X, Xiao G, et al. Excellent diagnostic performance of FNA-Tg in detecting lymph nodes metastases from papillary thyroid cancer. Future Oncol, 2020, 16(33): 2735-2746.
20. 李想, 黄韬, 刁畅, 等. 甲状腺球蛋白抗体和甲状腺过氧化物酶抗体状态对分化型甲状腺癌患者中央区淋巴结影响的多中心临床研究. 中国普外基础与临床杂志, 2020, 27(11): 1392-1396.
21. Hong CM, Jeong JH, Son SH, et al. Serum thyroglobulin elevation after needle aspiration of the lymph nodes: the predictive value for detecting metastasis in papillary thyroid cancer patients—a pilot study. Medicine (Baltimore), 2019, 98(31): e16461.
22. Wu X, Gu H, Gao Y, et al. Clinical outcomes and prognostic factors of radioiodine ablation therapy for lymph node metastases from papillary thyroid carcinoma. Nucl Med Commun, 2018, 39(1): 22-27.
23. 赵连春, 刘光霞, 陈芳, 等. 血清甲状腺球蛋白在分化型甲状腺癌术后转移的诊断预测效能分析. 热带医学杂志, 2020, 20(12): 1569-1572.
24. 高刘艳, 李素平. 甲状腺球蛋白和甲状腺球蛋白抗体在分化型甲状腺癌诊治中的价值. 国际放射医学核医学杂志, 2020, 44(3): 196-201.
25. Ronga G, Filesi M, Ventroni G, et al. Value of the first serum thyroglobulin level after total thyroidectomy for the diagnosis of metastases from differentiated thyroid carcinoma. Eur J Nucl Med, 1999, 26(11): 1448-1452.
26. Makarewicz J, Adamczewski Z, Rutkowski A, et al. An evaluation of the value of first thyroglobulin determination in the diagnostics of metastases immediately following differentiated thyroid carcinoma surgery. Endokrynol Pol, 2006, 57(4): 370-373.
27. Demir F, Şimşek FS, Ansal Balcı T. The role of pre-ablative stimulated thyroglobulin and thyroglobulin/thyroid-stimulating hormone ratio for predicting metastasis in thyroid cancer. Mol Imaging Radionucl Ther, 2019, 28(1): 21-26.
28. Prabhu M, Samson S, Reddy A, et al. Role of preablative stimulated thyroglobulin in prediction of nodal and distant metastasis on iodine whole-body scan. Indian J Nucl Med, 2018, 33(2): 93-98.
29. 陈鹏, 宋长祥, 陆武, 等. 术后刺激性甲状腺球蛋白水平预测分化型甲状腺癌功能性转移灶的价值. 中国医学影像学杂志, 2017, 25(6): 422-424, 429.
30. 王芳, 王越, 刁宏翠, 等. 分化型甲状腺癌术后再次 ¹³¹Ⅰ治疗前 sTg 与 sTg/sup-Tg 对淋巴结转移的预测价值. 现代肿瘤医学, 2020, 28(14): 2417-2421.
31. Park EK, Chung JK, Lim IH, et al. Recurrent/metastatic thyroid carcinomas false negative for serum thyroglobulin but positive by posttherapy I-131 whole body scans. Eur J Nucl Med Mol Imaging, 2009, 36(2): 172-179.
32. Campennì A, Giovanella L, Pignata SA, et al. Undetectable or low (< 1 ng/mL) postsurgical thyroglobulin values do not rule out metastases in early stage differentiated thyroid cancer patients. Oncotarget, 2018, 9(25): 17491-17500.
33. Silberstein EB. The problem of the patient with thyroglobulin elevation but negative iodine scintigraphy: the TENIS syndrome. Semin Nucl Med, 2011, 41(2): 113-120.
34. Song HJ, Xue YL, Qiu ZL, et al. Uncommon metastases from differentiated thyroid carcinoma. Hell J Nucl Med, 2012, 15(3): 233-240.
35. 夏亮, 陆涤宇, 周俊, 等. ¹³¹I-SPECT/CT 多模态显像联合超声及血清 Tg 对分化型甲状腺癌颈部淋巴结转移的诊断价值. 肿瘤学杂志, 2017, 23(4): 278-281.
36. Spanu A, Nuvoli S, Marongiu A, et al. Neck lymph node metastasis detection in patients with differentiated thyroid carcinoma (DTC) in long-term follow-up: a ¹³¹I-SPECT/CT study. BMC Cancer, 2020, 20(1): 239.
37. 范志娜, 吴刚, 袁建军. 超声联合血清 Tg、SPECT/CT 诊断分化型甲状腺癌术后颈部淋巴结转移. 中国医学影像技术, 2014, 30(3): 362-365.
38. 张瑞坚, 刘立衡, 刘巧爱, 等. 颈部超声联合甲状腺球蛋白检查对分化性甲状腺癌术后复发诊断的临床价值. 中国现代普通外科进展, 2019, 22(7): 515-517.
39. Moslehi M, Assadi M. Contribution of ultrasound examination in the detection of neck recurrence in low-risk differentiated thyroid carcinoma patients at first follow-up visits. Nucl Med Rev Cent East Eur, 2014, 17(1): 3-6.
40. Zhao T, Liang J, Li T, et al. Value of serial preablative thyroglobulin measurements: can we address the impact of thyroid remnants? Nucl Med Commun, 2016, 37(6): 632-639.
41. 赵腾, 梁军, 李田军, 等. 分化型甲状腺癌 ¹³¹I 治疗前刺激性 Tg 动态变化与远处转移的关系. 中国医学科学院学报, 2015, 37(3): 315-319.
42. Rowe ME, Osorio M, Likhterov I, et al. Evaluation of ultrasound reporting for thyroid cancer diagnosis and surveillance. Head Neck, 2017, 39(9): 1756-1760.
43. Ritter A, Mizrachi A, Bachar G, et al. Detecting recurrence following lobectomy for thyroid cancer: role of thyroglobulin and thyroglobulin antibodies. J Clin Endocrinol Metab, 2020, 105(6): dgaa152.
44. 魏伟军, 沈晨天, 宋红俊, 等. 超敏甲状腺球蛋白测定在分化型甲状腺癌随访中的应用. 中华核医学与分子影像杂志, 2016, 36(5): 474-478.
45. 何凯骅, 章斌, 陈志强, 等. 血清 sTg 和 TgAb 水平监测甲状腺乳头状癌患者低剂量碘-131 疗效的研究. 现代检验医学杂志, 2018, 33(6): 142-145.
46. 冯会娟, 欧阳伟, 孙云钢, 等. 甲状腺球蛋白水平与分化型甲状腺癌转移灶的关系. 广东医学, 2014, 35(6): 878-880, 881.
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Research progress of thyroglobulin in evaluating lymph node metastasis of differentiated thyroid carcinoma

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