Clinicopathological relevance of antithyroglobulin antibodies in low-risk papillary thyroid cancer

Abstract

Objective

The extent of initial surgical management in papillary thyroid cancer (PTC) is controversial. We examined whether the presence of perioperative antithyroglobulin antibodies (TGA) could predict long-term recurrence and occurrence of adverse features among a homogenous group of PTC patients.

Methods

The clinical features of PTC patients treated at a single institution (Jewish General Hospital, McGill University, Montreal, Canada) were obtained from the medical records and all clinicopathologic information were reviewed. Only low-risk PTC without clinical evidence of nodal disease before surgery and treated with 30mCi of radioactive iodine (RAI) were included in the study.

Results

The chart review retrieved 361 patients with a median follow-up of 85.0 months (Q25-Q75 73-98). Forty-two (11.6%) patients had presence of perioperative TGA. Perioperative TGAs were associated with present extrathyroidal extension (P=0.005), unsuspected nodal disease (P=0.001) and autoimmune thyroiditis (P<0.0001). Overall, 17 (4.7%) patients experienced locoregional recurrence. Perioperative TGAs were a significant predictor of recurrence in univariable (P=0.021) but not in multivariable analysis (P=0.13).

Conclusion

Presence of perioperative TGAs is associated with aggressive histological features and the presence of thyroiditis. Detection of TGA perioperatively may encourage surgeons to consider more extensive initial surgery.

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