scholarly journals Lymphocytic Thyroiditis on Histology Correlates with Serum Thyroglobulin Autoantibodies in Patients with Papillary Thyroid Carcinoma: Impact on Detection of Serum Thyroglobulin

2012 ◽  
Vol 97 (7) ◽  
pp. 2380-2387 ◽  
Author(s):  
Francesco Latrofa ◽  
Debora Ricci ◽  
Lucia Montanelli ◽  
Roberto Rocchi ◽  
Paolo Piaggi ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Thyroid ◽  
Serum Thyroglobulin ◽  
Lymphocytic Thyroiditis ◽  
Thyroglobulin Autoantibodies

scholarly journals MON-495 Influence of Lymphocytic Thyroiditis at Histology and Serum Thyroglobulin Autoantibodies on the Course of Papillary Thyroid Carcinoma

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Nicola Viola ◽  
Laura Agate ◽  
Sonia Caprio ◽  
Debora Ricci ◽  
Alessandro Brancatella ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Whole Body ◽  
Thyroid Autoantibodies ◽  
Papillary Thyroid ◽  
Serum Thyroglobulin ◽  
Neck Ultrasound ◽  
Thyroglobulin Autoantibodies ◽  
Structural Disease

Abstract PURPOSE Papillary thyroid carcinoma (PTC) is frequently associated with diffuse lymphocytic thyoiditis (LT) at histology and serum autoantibodies to thyroglobulin (TgAb) and to thyroperoxidase (TPOAb). The influence of LT and thyroid autoantibodies on the prognosis of PTC is debated. We evaluated the clinical course of a large group of PTC patients according to the presence or absence of LT (LT+ and LT-) and thyroid autoantibodies. METHODS We evaluated 194 consecutive and non-selected PTC patients treated with total thyroidectomy plus ¹³¹I ablation between 2007 and 2009, followed for 7.2 years (mean). 72 patients had follicular variant of PTC, 97 classic, 16 tall cells and the remaining 9 others variants (solid or oxyphilic cells). LT was diagnosed in presence of >10 lymphocytes/field (40x). At the time of ablation, all patients underwent measurement of Tg, TgAb and TPOAb, neck ultrasound and whole body scan. After ablation, patients underwent Tg (Beckman Coulter), TgAb and TPOAb (Tosoh) measurement and neck ultrasound (associated with other imaging if required) every 6-12 months. PTC was considered in remission according to the following criteria: un-stimulated Tg <0.2 ng/mL or stimulated Tg <1 ng/mL with TgAb <8 IU/mL and no evidence of structural disease. PTC was considered as persistent when un-stimulated Tg was ≥0.2 ng/mL or stimulated Tg was ≥1 ng/mL, or when TgAb were ≥8 IU/mL, or there was evidence of structural disease. RESULTS LT was found in 47% of patients, with a F/M ratio of 6.6/1, and was associated with a hypoechoic pattern at thyroid ultrasound (p = 0.05). At the end of follow-up 44/194 (22.7%) had persistent disease. Among them, 17/72 (23.6%) were follicular, 19/97 (19.6%) classic, 6/16 (37.5%) tall cells and 2/9 (22.2%) other variants. The time to remission was longer in the LT+ compared to the LT- patients (19.5 vs 7.5 months) (median) (p <0.001), in TgAb positive compared to TgAb negative patients (28.5 vs 7.5 months) (p <0.001) and in TPOAb positive compared to TPOAb negative patients (28.0 vs 8.0 months) (p = 0.005). At multivariate analysis TgAb were the only independent factor influencing the time to remission (0.54; 0.35-0.83; HR and confidence interval) (p = 0.001). However, evaluating only the 111 TgAb negative patients, the time to remission (undetectable un-stimulated or stimulated Tg and no evidence of structural disease) was similar in the LT+ and LT- groups (8.0 months for both). At variance, in 83 TgAb positive patients the time to remission was longer in LT+ than in LT- patients (29.3 vs 13.0 months) (p=0.01). CONCLUSIONS The time to remission is longer in LT+ compared to LT- PTC patients treated with total thyroidectomy plus ¹³¹I ablation. This is due to the frequent association of LT with TgAb, because undetectable TgAb is required to define the remission of PTC. Indeed, coexistent LT does not influence the time to remission when the analysis is restricted to TgAb negative patients.

scholarly journals Thyroglobulin Autoantibodies in Patients with Papillary Thyroid Carcinoma: Comparison of Different Assays and Evaluation of Causes of Discrepancies

2012 ◽  
Vol 97 (11) ◽  
pp. 3974-3982 ◽  
Author(s):  
Francesco Latrofa ◽  
Debora Ricci ◽  
Lucia Montanelli ◽  
Roberto Rocchi ◽  
Paolo Piaggi ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Hashimoto’S Thyroiditis ◽  
Surrogate Marker ◽  
Normal Subjects ◽  
Differentiated Thyroid Carcinoma ◽  
Hashimoto's Thyroiditis ◽  
Papillary Thyroid ◽  
Lymphocytic Thyroiditis ◽  
Thyroglobulin Autoantibodies

Context: Thyroglobulin autoantibodies (TgAb) have been proposed as a surrogate marker of thyroglobulin in the follow-up of differentiated thyroid carcinoma. Commercially available TgAb assays are often discordant. We investigated the causes of discrepancy. Design: TgAb were measured by three noncompetitive immunometric assays and three competitive RIA in 72 patients with papillary thyroid carcinoma and associated lymphocytic thyroiditis (PTC-T), 105 with papillary thyroid carcinoma and no lymphocytic thyroiditis (PTC), 160 with Hashimoto's thyroiditis, and in 150 normal subjects. The results of the six assays were correlated. TgAb epitope pattern, evaluated by inhibition of serum TgAb binding to thyroglobulin by TgAb-Fab regions A, B, C, and D, were compared in sera which were positive in all six assays (concordant sera) and positive in only one to five assays (discordant sera) were compared. TgAb International Reference Preparation (IRP) was measured in 2007 and 2009. Results: The correlations of the six assays ranged from −0.01 to 0.93 and were higher in PTC-T and Hashimoto's thyroiditis than in PTC and normal subjects. Two uncorrelated components, one including the three immunometric assays, the other the three RIA, explained 40 and 37% of the total variance of the results of the six assays. The levels of inhibition were higher in concordant sera than in discordant sera by TgAb-Fab region B (27.0%, 21.2–34.0 vs. 6.0%, and 2.7–12.7%) and region C (30.5%, 21.3–37.7 vs. 4.0%, and 1.0–6.5%); thus, the epitope pattern was more homogeneous in concordant sera than in discordant sera. TgAb IRP ranged from 157 to 1088 (expected 1000) IU/ml in 2009; results in 2007 were similar in all but two assays. Conclusions: TgAb assays are highly discordant. Discrepancy is lower when comparing assays with similar methodology. Results of TgAb from PTC-T are more concordant than those from PTC because their epitope pattern is more restricted. The internal standardization of TgAb is generally, but not completely, satisfactory.

scholarly journals Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhichao Xing ◽  
Yuxuan Qiu ◽  
Zhe Li ◽  
Lingyun Zhang ◽  
Yuan Fei ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Total Thyroidectomy ◽  
Radioactive Iodine ◽  
Independent Predictor ◽  
Central Neck Dissection ◽  
American Thyroid Association ◽  
Papillary Thyroid ◽  
Serum Thyroglobulin

Abstract Background To investigate the association between postoperative lymph nodes (LNs) recurrence and distinct serum thyroglobulin (Tg) levels in patients with papillary thyroid carcinoma (PTC). Methods This study included PTC patients who underwent total thyroidectomy (TT) with at least central neck dissection and then re-operated due to recurrence of LNs between January 2013 and June 2018. These patients were grouped by negative or positive serum Tg levels according to the American Thyroid Association guidelines. Results Of the 60 included patients, 49 underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), and higher rate of metastatic LNs (P < 0.001). Serum-stimulated Tg (off-Tg) ≥ 1 ng/mL (P = 0.047) and unstimulated Tg (on-Tg) ≥ 0.2 ng/Ml (P = 0.013) were associated with larger diameter of recurrent LNs. Number of metastatic LNs ≥ 8 was an independent predictor for postoperative maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392–55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649–267.384; P = 0.019). Conclusion Postoperative Tg-positive status was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 and ratio of metastatic LNs ≥ 25% were independent predicators for uTg-positive and off-Tg-positive status, respectively.

scholarly journals Cytomorphological features of oncocytic variant of papillary thyroid carcinoma with lymphocytic thyroiditis

2016 ◽  
Vol 02 (02) ◽  
pp. 085-087 ◽  
Author(s):  
Nivedita Patnaik ◽  
Preeti Diwaker ◽  
Alphy Varughese ◽  
Vinod Arora ◽  
Bharat Singh
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Autoimmune Thyroiditis ◽  
Needle Aspiration ◽  
Surrounding Tissue ◽  
Papillary Thyroid ◽  
Diagnostic Dilemma ◽  
Lymphocytic Thyroiditis ◽  
Wide Range ◽  
Oncocytic Variant

AbstractCytological diagnosis of hurthle cell lesions of thyroid is a diagnostic dilemma. Presence of hurthle cells on fine needle aspiration (FNA) leads to a wide range of differential diagnosis including benign and malignant entities. The oncocytic variant of papillary thyroid carcinoma (PTC) is one entity of the vast list of differentials of which very few cases have been reported to date. We report a case of oncocytic variant of PTC in a 28-year-old female diagnosed on cytomorphology. The findings of FNA smears of the first aspirate were not sufficient for a definitive diagnosis. Repeat FNA was done to rule out the possibility of autoimmune thyroiditis/thyroid neoplasm. The repeat FNA smears showed oncocytic cells present in papillary and loosely cohesive clusters. Many of the cells displayed nuclear features of PTC and the case was finally diagnosed as PTC; oncocytic variant. Thyroidectomy specimen revealed PTC; oncocytic variant with lymphocytic thyroiditis in the surrounding tissue. Thus, in cytology practice, concurrent autoimmune thyroiditis may pose a problem in diagnosis of PTC; oncocytic variant.

scholarly journals Predictors of Thyroglobulin in the Lymph Nodes Recurrence of Papillary Thyroid Carcinoma Undergoing Total Thyroidectomy

2020 ◽  
Author(s):  
Zhichao Xing ◽  
Yuxuan Qiu ◽  
Zhe Li ◽  
Lingyun Zhang ◽  
Yuan Fei ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Total Thyroidectomy ◽  
Radioactive Iodine ◽  
Independent Predictor ◽  
Structural Features ◽  
Papillary Thyroid ◽  
Serum Thyroglobulin ◽  
Positive Ratio

Abstract Purpose To investigate serum thyroglobulin (Tg) levels in papillary thyroid carcinoma (PTC) patients with lymph nodes (LNs) recurrence, thereby evaluating possible risk factors and structural features of LNs recurrence. Methods All the patients with primary PTC who underwent total thyroidectomy (TT) with central or lateral neck dissection and then re-operated due to LNs recurrence between January 2013 and June 2018 were included. Patients were subdivided groups by different Tg levels. Results This study included 60 patients with LNs recurrence. Of all, 49 patients underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), higher possibility of diameters of recurrent LNs ≥ 25 mm (P = 0.023) and higher ratio of metastatic LNs (P < 0.001). Pre-RAI ablation serum-stimulated Tg (off-Tg) ≥ 1 ng/mL and unstimulated Tg detected at 1 week after RAI ablation (on-Tg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs and higher possibility of diameters of recurrent LNs ≥ 25 mm. Number of metastatic LNs ≥ 8 was an independent predictor for maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392–55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649-267.384; P = 0.019). Conclusion Tg-positive was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 could independently predict maximum uTg-positive. Ratio of metastatic LNs ≥ 25% was an independent predicator for off-Tg-positive.

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