AUTHOR=Han Na , Lu Chenghui , Li Jiao , Wang Congcong , Zhao Zilong , Zhang Yingying , Liu Xinfeng , Si Zengmei , Wang Guoqiang , Wang Zenghua , Li Fengqi , Wang Xufu 

TITLE=Stimulated thyroglobulin and pre-ablation antithyroglobulin antibody products can predict the response to radioiodine therapy of TgAb-positive differentiated thyroid cancer patients: a retrospective study

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1222470

DOI=10.3389/fendo.2023.1222470

ISSN=1664-2392

ABSTRACT=Objective We aimed to explore the predictive value of stimulated thyroglobulin (sTg) and pre-ablation antithyroglobulin (pa-TgAb) products for the effect of radioiodine therapy (RAIT) in TgAb-positive differentiated thyroid cancer (DTC) patients.
Methods In this study, we enrolled 265 patients with TgAb-positive DTC who underwent RAIT after total thyroidectomy (TT). Based on the last follow-up result, the patients were divided into two groups: the excellent response (ER) group and the non-excellent response (NER) group. We analyzed the factors related to the effect of RAIT.
Results The ER group consisted of 197 patients. The NER group consisted of 68 patients. For the univariate analysis, we found that maximal tumor diameter, whether with extrathyroidal extension (ETE), bilateral or unilateral primary lesion, multifocality, preop-TgAb, pa-TgAb, sTg×pa-TgAb, initial RAIT dose, N stage and surgical extent (modified radical neck dissection or not) showed significant differences in the ER group and NER group (all p-values<0.05). ROC curves showed that the cutoff value was 724.25 IU/ml, 424.00 IU/ml, and 59.73 for preop-TgAb, pa-TgAb, and sTg×pa-TgAb, respectively. The multivariate logistic regression analysis results indicated that pa-TgAb, sTg×pa-TgAb, initial RAIT dose and N stage were independent risk factors for NER (all p-values<0.05). For the Kaplan‒Meier analysis of DFS, the median DFS of the patients with sTg×pa-TgAb<59.73 and initial RAIT dose ≤100mCi was significantly longer than that of the patients with sTg×pa-TgAb≥59.73 (50.27 months vs. 48.59months, p=0.041) and initial RAIT dose＞100mCi (50.50months vs. 38.00months, p=0.030).
Conclusion We found that sTg and pa-TgAb conduct is a good predictor of efficacy to RAIT in TgAb-positive DTC patients. It can play a very positive and important role in optimizing treatment, improving prognosis and reducing the burden of patients.