Comparison of Prognostic Value Between Stimulated and Nonstimulated Thyroglobulins in Differentiated Thyroid Cancer: A Retrospective Study.

IF 17.7 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-12-01 Epub Date: 2023-07-03 DOI:10.1007/s13139-023-00811-8
Junik Son, Chae Moon Hong, Do-Hoon Kim, Shin Young Jeong, Sang-Woo Lee, Jaetae Lee, Byeong-Cheol Ahn
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Abstract

Purpose: The growing incidence of differentiated thyroid cancer (DTC) demands dependable prognostic factors to guide follow-up and treatment plans. This study investigated the prognostic value of response to therapy (RTT) assessment using TSH stimulated-thyroglobulin (sti-Tg) and nonstimulated-thyroglobulin (nonsti-Tg) and evaluates whether RTT using nonsti-Tg (nonstiRTT) can replace RTT using sti-Tg (stiRTT) in clinical practice to improve patients' quality of life during assessment.

Methods: We enrolled 419 DTC patients who underwent total thyroidectomy, radioactive iodine (RAI) therapy, and Tg assessment. Patients with structural incomplete responses were excluded. Initial RTT assessments based on the 2015 American Thyroid Association guidelines (excellent response; ER, indeterminate response, biochemical incomplete response) were performed 6-24 months after RAI therapy. The second RTT assessments were performed 6-24 months after the first assessment. Statistical analysis for recurrence-free survival (RFS) was done with the log-rank test for stiRTT and nonstiRTT.

Results: Although initial stiRTT and nonstiRTT were significant predictors for RFS (p < 0.0001), stiRTT provided better RFS prediction than nonstiRTT. The RFS analysis of the second RTT assessment demonstrated statistical significance only for stiRTT (p < 0.0001). In 116 patients classified as ER on initial stiRTT, there was no RFS difference between patients classified as ER on either second stiRTT or nonstiRTT.

Conclusion: The prognostic power of stiRTT surpasses that of nonstiRTT in both the initial and second RTT assessment. Nevertheless, among patients classified as ER on initial stiRTT, a second stiRTT may not be required for those classified as ER on the second nonstiRTT.

Supplementary information: The online version contains supplementary material available at 10.1007/s13139-023-00811-8.

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受激与非受激甲状腺球蛋白对分化型甲状腺癌预后价值的比较:回顾性研究
目的:分化型甲状腺癌(DTC)的发病率不断上升,需要可靠的预后因素来指导随访和治疗计划。本研究探讨了TSH促甲状腺球蛋白(stii - tg)和非促甲状腺球蛋白(nonstii - tg)对治疗反应(RTT)评估的预后价值,并评估了在临床实践中使用非stii - tg (nonstiRTT)的RTT是否可以替代stii - tg (stiRTT)的RTT,以改善患者在评估期间的生活质量。方法:我们招募了419名接受甲状腺全切除术、放射性碘(RAI)治疗和Tg评估的DTC患者。排除结构不完全反应的患者。基于2015年美国甲状腺协会指南的初始RTT评估(反应优异;在RAI治疗后6-24个月进行ER、不确定缓解、生化不完全缓解。第二次RTT评估在第一次评估后6-24个月进行。对stiRTT和非stiRTT的无复发生存率(RFS)进行log-rank检验。结果:虽然初始stiRTT和非stiRTT是RFS的重要预测因子(p)。结论:在初始和第二次RTT评估中,stiRTT的预后能力都超过非stiRTT。然而,在首次stiRTT时被归类为ER的患者中,对于第二次非stiRTT时被归类为ER的患者可能不需要第二次stiRTT。补充信息:在线版本提供补充资料,网址为10.1007/s13139-023-00811-8。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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