Objective

Clinical and laboratory guidelines recommend thyroglobulin antibodies (TgAbs) measurement with every thyroglobulin (Tg) measurement for the follow-up of differentiated thyroid cancer (DTC) patients. However, no evidence exists on the need for perpetual TgAbs testing in patients who are TgAb-negative at baseline. Our study was carried out to evaluate the prevalence, the dynamic changes, and the clinical significance of TgAbs that appeared de novo during the follow-up of DTC patients who were TgAb-negative at baseline.

Methods

The data of DTC patients with negative pre-ablation TgAbs were reviewed retrospectively. The main characteristics of patients with both transient and sustained de novo TgAbs appearance were analyzed. DTC patients with persistently negative TgAbs served as controls.

Results

Among 119 patients with pre-ablation negative TgAbs, 14 cases (11.7%) with de novo TgAbs appearance (10 and 4 patients with a transient and sustained de novo TgAbs appearance, respectively) were detected. No differences in disease-free survival were observed in patients with de novo TgAbs appearance compared to controls. The TgAbs peak value was higher in patients with sustained de novo appearance compared to patients with transient de novo. Two of 14 patients with de novo TgAbs developed structural disease with concurrently detectable Tg in both cases.

Conclusions

Transient de novo TgAbs appearance is not infrequent during DTC patients’ follow-up, and it has no apparent clinical impact. Sustained de novo TgAbs appearance is rare and may predict structural recurrences; however, similar disease-free survival was observed in patients with sustained de novo TgAbs and TgAb-negative DTC patients.

中文翻译：

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分化型甲状腺癌患者甲状腺球蛋白抗体“从头”出现的意义

客观的

临床和实验室指南建议甲状腺球蛋白抗体 (TgAbs) 测量与每次甲状腺球蛋白 (Tg) 测量结果一起用于分化型甲状腺癌 (DTC) 患者的随访。然而，没有证据表明需要对基线时 TgAb 阴性的患者进行永久 TgAb 检测。我们的研究旨在评估基线时 TgAb 阴性的 DTC 患者在随访期间新出现的 TgAb 的患病率、动态变化和临床意义。

方法

回顾性回顾了消融前 TgAb 阴性的 DTC 患者的数据。分析了具有短暂性和持续性新发 TgAb 外观的患者的主要特征。具有持续阴性 TgAb 的 DTC 患者作为对照。

结果

在消融前阴性 TgAb 的 119 例患者中，检测到 14 例 (11.7%) 具有从头 TgAb 外观（分别为 10 和 4 例具有短暂和持续的从头 TgAb 外观的患者）。与对照组相比，在具有新生 TgAb 外观的患者中未观察到无病生存率的差异。与短暂性新发患者相比，持续性新发患者的 TgAbs 峰值更高。14 名具有 de novo TgAbs 的患者中有 2 名发生了结构性疾病，在这两种情况下都可同时检测到 Tg。

结论

在 DTC 患者的随访期间，短暂的从头 TgAb 出现并不少见，并且没有明显的临床影响。持续的从头 TgAb 出现很少见，可能预示着结构性复发；然而，在持续性新发 TgAb 和 TgAb 阴性 DTC 患者中观察到类似的无病生存期。