Comparison of seven serum thyroglobulin assays in the follow-up of papillary and follicular thyroid cancer patients

Martin Schlumberger, A. Hitzel, M. E. Toubert, C. Corone, F. Troalen, M. H. Schlageter, F. Claustrat, S. Koscielny, D. Taieb, M. Toubeau, F. Bonichon, F. Borson-Chazot, L. Leenhardt, C. Schvartz, C. Dejax, I. Brenot-Rossi, M. Torlontano, F. Tenenbaum, S. Bardet, F. BussièreJ. J. Girard, O. Morel, O. Schneegans, J. L. Schlienger, A. Prost, D. So, F. Archambeaud, M. Ricard, E. Benhamou

Research output: Contribution to journalArticlepeer-review


Background: Serum thyroglobulin (Tg) is the marker of differentiated thyroid cancer after initial treatment and TSH stimulation increases its sensitivity for the diagnosis of recurrent disease. Aim: The goal of the study is to compare the diagnostic values of seven methods for serum Tg measurement for detecting recurrent disease both during L-T4 treatment and after TSH stimulation. Methods: Thyroid cancer patients who had no evidence of persistent disease after initial treatment (total thyroidectomy and radioiodine ablation) were studied at 3 months on L-T4 treatment (Tg1) and then at 9-12 months after withdrawal or recombinant human TSH stimulation (Tg2). Sera with anti-Tg antibodies or with an abnormal recovery test result were excluded from Tg analysis with the corresponding assay. The results of serum Tg determination were compared to the clinical status of the patient at the end of follow-up. Results: Thirty recurrences were detected among 944 patients. A control 131I total body scan had a low sensitivity, a low specificity, and a low clinical impact. Assuming a common cutoff for all Tg assays at 0.9 ng/ml, sensitivity ranged from 19-40% and 68-76% and specificity ranged from 92-97% and 81-91% for Tg 1 and Tg2, respectively. Using assays with a functional sensitivity at 0.2-0.3 ng/ml, sensitivity was 54-63% and specificity was 89% for Tg1. Using the two methods with a lowest functional sensitivity at 0.02 and 0.11 ng/ml resulted in a higher sensitivity for Tg1 (81% and 78%), but at the expense of a loss of specificity (42% and 63%); finally, for these two methods, using an optimized functional sensitivity according to receiver operating characteristic curves at 0.22 and 0.27 ng/ml resulted in a sensitivity at 65% and specificity at 85-87% for Tg1. Conclusion: Using an assay with a lower functional sensitivity may give an earlier indication of the presence of Tg in the serum on L-T4 treatment and may be used to study the trend in serum Tg without performing any TSH stimulation. Serum Tg determination obtained after TSH stimulation still permits a more reliable assessment of cure and patient's reassurance.

Original languageEnglish
Pages (from-to)2487-2495
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Issue number7
Publication statusPublished - Jul 2007

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism


Dive into the research topics of 'Comparison of seven serum thyroglobulin assays in the follow-up of papillary and follicular thyroid cancer patients'. Together they form a unique fingerprint.

Cite this