Background: Thyroglobulin (Tg) is the specific tumor marker for epithelial thyroid cancer. It holds significant value in the postoperative period, and somehow, the goal of surgery in papillary thyroid cancer (PTC) undergoing total thyroidectomy is to achieve undetectable levels of postoperative thyroglobulin (uTg).Methods: This is a retrospective single-center study in which first basal Tg values were evaluated post-surgery in PTC patients undergoing total thyroidectomy. Patients with elevated antithyroglobulin antibodies were excluded. The impact of various demographic, clinical, therapeutic, tumor-stage related, and histopathological variables on the achievement of undetectable thyroglobulin levels (uTg, <1 ng/mL) was studied. A descriptive and logistic regression-based bivariate and multivariate analysis was planned using STATA vs. 16.1. program. The significance level was stated at 0.05.Results: Basal athyroglobulinemia was obtained in 89.6% of 202 patients operated on between January 2015 and June 2023 in a single referral institution. Due to the limited number of cases with detectable Tg, multivariate analysis could not be performed. The main factors that favored its achievement on bivariate analysis were a smaller tumor size (p= 0.003), no need for extended resections due to local invasion beyond the thyroid gland (p= 0.003) or neck dissection (p= 0.039), absence of distant metastases (p= 0.000), and a lower MACIS score (p< 0.000).Conclusions: The achievement of uTg was closely related to factors related to tumor stage (tumor diameter, lymph node spread, and metastatic disease), and it was not influenced by differences in epidemiological data, clinic manifestations, preoperative diagnosis, multifocality, or the presence of aggressive cytological variants.
背景：甲状腺球蛋白（Tg）是甲状腺上皮癌的特异性肿瘤标志物，在术后管理中具有重要价值。对于接受全甲状腺切除术的甲状腺乳头状癌（PTC）患者，手术目标之一是实现术后甲状腺球蛋白不可检测水平（uTg）。 方法：本研究为回顾性单中心研究，评估了接受全甲状腺切除术的PTC患者术后首次基础Tg值。排除了抗甲状腺球蛋白抗体升高的患者。研究分析了人口统计学、临床特征、治疗方案、肿瘤分期相关因素及组织病理学变量对实现甲状腺球蛋白不可检测水平（uTg，<1 ng/mL）的影响。采用STATA 16.1软件进行描述性分析及基于逻辑回归的双变量与多变量分析，显著性水平设定为0.05。 结果：在2015年1月至2023年6月期间于单一转诊机构接受手术的202例患者中，89.6%实现了基础甲状腺球蛋白不可检测。由于可检测Tg的病例数有限，未能进行多变量分析。双变量分析显示，有利于实现uTg的主要因素包括：较小肿瘤直径（p=0.003）、无需因甲状腺外局部侵犯（p=0.003）或颈清扫术（p=0.039）进行扩大切除、无远处转移（p=0.000）以及较低的MACIS评分（p<0.000）。 结论：uTg的实现与肿瘤分期相关因素（肿瘤直径、淋巴结转移及远处转移）密切相关，不受流行病学数据差异、临床表现、术前诊断、多灶性或侵袭性细胞学亚型存在的影响。
Predictive Factors of Athyroglobulinemia After Total Thyroidectomy for Papillary Thyroid Cancer
肿瘤(癌症)患者之家