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Am J Surg. 2010 Jul;200(1):41-6. doi: 10.1016/j.amjsurg.2009.08.030.

Serum thyroglobulin is a poor diagnostic biomarker of malignancy in follicular and Hurthle-cell neoplasms of the thyroid.

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  • 1Department of Surgery, University of California-San Francisco, 513 Parnassus Ave., San Francisco, CA 94143-0470, USA. insoo.suh@ucsfmedctr.org

Abstract

BACKGROUND:

Serum thyroglobulin (Tg) is the most accurate biomarker for thyroid cancer recurrence. However, some clinicians measure preoperative Tg as a diagnostic cancer marker despite lack of supporting evidence. We examined whether Tg accurately predicts malignancy in follicular or Hürthle-cell neoplasms.

METHODS:

We reviewed 366 patients who underwent thyroidectomies for follicular/Hürthle-cell neoplasms. We compared Tg in malignant versus benign tumors by univariate and receiver-operator characteristic analyses. We also examined several Tg-derived indices that normalized Tg to known confounding factors including nodule size, thyroid function, and type of Tg assay.

RESULTS:

Thirty-nine patients met inclusion criteria for analysis. There were no differences between malignant (n = 16) and benign (n = 23) lesions in Tg or any of the normalized indexes. Receiver-operator characteristic analysis revealed an area under the curve of .59. Lesions with Tg levels greater than 500 mug/L had a positive predictive value of .75.

CONCLUSIONS:

Tg has poor accuracy for predicting malignancy in follicular or Hürthle-cell thyroid neoplasms.

Copyright (c) 2010 Elsevier Inc. All rights reserved.

[PubMed - indexed for MEDLINE]
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