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. 2009 Sep 22;23(5):341–346. doi: 10.1002/jcla.20339

Comparison of the influence of thyroglobulin antibodies on serum thyroglobulin values from two different immunoassays in post surgical differentiated thyroid carcinoma patients

Marijana Stanojevic 1, Svetlana Savin 2, Dubravka Cvejic 2, Aleksandar Djukic 1, Marija Jeremic 3, Snezana Zivancević Simonovic 1,✉
PMCID: PMC6649009  PMID: 19774624

Abstract

Measurement of serum thyroglobulin (Tg) is a highly specific test in the management of patients with differentiated thyroid cancer (DTC) after surgical treatment. The aim of our study was to evaluate and compare Tg levels in these patients found by radioimmunoassay (RIA) and immunoradiometric assay (IRMA) and to assess the influence of Tg antibodies (TgAbs) on the values obtained for Tg concentration. Both Tg and TgAb were determined postoperatively in the serum of 71 DTC patients using RIA Tg‐PEG (INEP) and Tg IRMA (CIS) for Tg, together with TgAb (CIS) for circulating endogenous anti‐TgAbs. The obtained concentrations were evaluated statistically. We found a significant difference of Tg concentrations between paired samples from the IRMA and RIA, although the intermethod comparison yielded satisfactory concordance of the twoassays (Spearman correlation coefficient −0.792). Positive TgAb was found in 28.2% of the serum samples analyzed. Spearman rank correlation analysis revealed a significant negative relationship between serum TgAb and Tg level measured by IRMA (P=0.02), but not by RIA (P=0.417). On the other hand, our clinical data revealed that 1/18 and 3/18 patients with proven lymph node metastasis had Tg values below the detection limit by RIA and IRMA assay, respectively. Their sera were TgAb positive. We concluded that RIA was less prone to influence of TgAb than IRMA. As the presence of TgAbs may interfere in Tg measurement irrespective of the method selected for determination, this should be considered during the clinical management of these patients. J. Clin. Lab. Anal. 23:341–346, 2009. © 2009 Wiley‐Liss, Inc.

Keywords: thyroglobulin, antithyroglobulin autoantibodies, radioimmunoassay, immunoradiometric assay, differentiated thyroid cancer

REFERENCES

  • 1. Demers LM, Spencer CA 7–13‐2002 Laboratory support for the diagnosis and monitoring of thyroid disease. http://www.nacb.org/lmpg/thyroidLMPG.stm. [DOI] [PubMed]
  • 2. Mazzaferri EL, Robbins RJ, Spencer CA, et al. A consensus report of the role of serum thyroglobulin as a monitoring method for low‐risk patients with papillary thyroid carcinoma. J Clin Endocrinol Metab 2003;88:1433–1441. [DOI] [PubMed] [Google Scholar]
  • 3. Spencer CA, Takeuchi M, Kazarosyan M, et al. Serum thyroglobulin autoantibodies: Prevalence, influence on serum thyroglobulin measurement, and prognostic significance in patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab 1998;83:1121–1127. [DOI] [PubMed] [Google Scholar]
  • 4. Spencer CA, Wang CC. Thyroglobulin measurement. Techniques, clinical benefits, and pitfalls. Endocrinol Metab Clin North Am 1995;24:841–863. [PubMed] [Google Scholar]
  • 5. Clark PM, Beckett G. Can we measure serum thyroglobulin? Ann Clin Biochem 2002;39:196–202. [DOI] [PubMed] [Google Scholar]
  • 6. Spencer CA, Takeuchi M, Kazarosyan M. Current status and performance goals for serum thyroglobulin assays. Clin Chem 1996;42:164–173. [PubMed] [Google Scholar]
  • 7. Spencer CA, Bergoglio LM, Kazarosyan M, Fatemi S, LoPresti JS. Clinical impact of thyroglobulin (Tg) and Tg autoantibody method differences on the management of patients with differentiated thyroid carcinomas. J Clin Endocrinol Metab 2005;90: 5566–5575. [DOI] [PubMed] [Google Scholar]
  • 8. Tortajada Genaro LA, Cozar MP, Moreno Frigols JL, Romero de Avila C. Comparison of immunoradiometric assays for determination of thyroglobulin: A validation study. J Clin Lab Anal 2007;21:147–153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9. Black EG Hoffenberg R. Should one measure serum thyroglobulin in the presence of anti‐thyroglobulin antibodies? Clin Endocrinol 1983;19:597–601. [DOI] [PubMed] [Google Scholar]
  • 10. Mariotti S, Barbesino G, Caturegli P, et al. Assay of thyroglobulin in serum with thyroglobulin autoantibodies: An unobtainable goal? J Clin Endocrinol Metab 1995;80:468–472. [DOI] [PubMed] [Google Scholar]
  • 11. Massart C Maugendre D. Importance of the detection method for thyroglobulin antibodies for the validity of thyroglobulin measurements in sera from patients with Graves' disease. Clin Chem 2002;48:102–107. [PubMed] [Google Scholar]
  • 12. Stanojević M, Savin S, Cvejić D, Đukić A, Živančević Simonović S. Correlation of thyroglobulin concentrations measured by radioimmunoassay and immunometric assay and the influence of thyroglobulin antibody. J Immunoassay Immunochem 2009;30:197–207. [DOI] [PubMed] [Google Scholar]
  • 13. Spencer CA. J Editorial: Challenges of serum thyroglobulin (Tg) measurement in the presence of Tg autoantibodies. Clin Endocrinol Metab 2004;89:3702–3704. [DOI] [PubMed] [Google Scholar]
  • 14. Spencer CA, Wang C, Fatemi S, Guttler RB, Takeuchi M Kazarosyan M. Serum thyroglobulin autoantibodies: Prevalence, influence on serum thyroglobulin measurement and prognostic significance in patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab 1998;83:1121–1127. [DOI] [PubMed] [Google Scholar]
  • 15. Cubero JM, Rodriques‐Espinosa J, Gelpi C, Estorch M, Corcoy R. Thyroglobulin autoantibody levels below the cut‐off positivity can interfere with thyroglobulin measurement. Thyroid 2003;13:659–661. [DOI] [PubMed] [Google Scholar]
  • 16. http://www.medicrit.com/libros/TIROIDES/6a.pdf.
  • 17. Stanojević M, Petrović M, Đukić A, Savin S, Dimitrijević Lj, Živančević Simonović S. Uticaj antitireoglobulinskih antitela na koncentraciju tireoglobulina izmerenu imunoradiometrijskim testom. Medicinski časopis 2007;41:1. [Google Scholar]
  • 18. Spencer CA. Recoveries cannot be used to authenticate thyroglobulin (Tg) measurements when sera contain Tg autoantibodies. Clin Chem 1996;42:661–663. [PubMed] [Google Scholar]
  • 19. Ferrari L, Biancolini D, Seregni E, et al. Critical aspects of immunoradiometric thyroglobulin assays. Tumori 2003;89:537–539. [DOI] [PubMed] [Google Scholar]
  • 20. Schultz R, Bethauser H, Stempka L, Heilig B, Moll A, Hufner M. Evidence for immunological differences between circulating and tissue‐derived thyroglobulin in men. J Clin Invest 1989;19:459–463. [DOI] [PubMed] [Google Scholar]
  • 21. Kumar A, Shah Dh, Shrihari U, Dandekar SR, Vijayan U, Sharma SM. Significance of antithyroglobulin autoantibodies in differentiated thyroid carcinoma. Thyroid 1994;4:199–202. [DOI] [PubMed] [Google Scholar]
  • 22. Rubello D, Casara D, Girelli ME, Piccolo M, Busnardo B. Clinical meaning of circulating antithyroglobulin antibodies in differentiated thyroid cancer: A prospective study. J Nucl Med 1992;33:1478–1480. [PubMed] [Google Scholar]
  • 23. Lukinac Lj, Krilić D, Nothing‐Hus D, Kusić Z. The problem of thyroid antibodies testing. Acta Clin Croat 2004;43:355–359. [Google Scholar]
  • 24. Kohse KP, Wisser H. Antibodies as a source of analytical errors. J Clin Chem Biochem 1990;28:881–892. [PubMed] [Google Scholar]
  • 25. Görges R, Maniecki M, Jentzen W, et al. Development and clinical impact of thyroglobulin antibodies in patients with differentiated thyroid carcinoma during the first 3 years after thyroidectomy. Eur J Endocrinol 2005;153:49–55. [DOI] [PubMed] [Google Scholar]
  • 26. Feldt‐Rasmussen U, Rasmussen AK. Serum thyroglobulin in presence of thyroglobulin autoantibodies in vitro and in vivo. Clinical and methodological relevance. J Clin Invest 1985;8:571–576. [DOI] [PubMed] [Google Scholar]
  • 27. Schneider AB, Pervos R. Radioimmunoassay of human thyroglobulin: Effect of antithyroglobulin autoantibodies. J Clin Endocrinol Metab 1978;47:126–137. [DOI] [PubMed] [Google Scholar]
  • 28. Schaadt B, Feldt‐Rasmussen U, Rasmusson B, et al. Assessment of the influence of thyroglobulin (Tg) autoantibodies and other interfering factors on the use of serum Tg as tumor marker in differentiated thyroid carcinoma. Thyroid 1995;5:165–170. [DOI] [PubMed] [Google Scholar]
  • 29. Feldt‐Rasmussen U, Schlumberger M. European interlaboratory comparison of serum thyroglobulin measurement. J Endocrinol Invest 1988;11:175–181. [DOI] [PubMed] [Google Scholar]
  • 30. Spencer CA, LoPresti JS, Fatemi S, Nicoloff JT. Detection of residual and recurrent differentiated thyroid carcinoma by serum thyroglobulin measurement. Thyroid 1999;9:435–441. [DOI] [PubMed] [Google Scholar]
  • 31. Spencer CA. New insights for using serum thyroglobulin (Tg) measurement for managing patients with differentiated thyroid carcinomas. Thyroid Int 2003;4:1–14. [Google Scholar]
  • 32. Baloch Z, Carayon P, Conte‐Devolx B, et al. Guidelines Committee, National Academy of Clinical Biochemistry. Laboratory medicine practice guidelines: laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid 2003;13:3–126. [DOI] [PubMed] [Google Scholar]
  • 33. Pacini F, Mariotti S, Formica N, Elisei R. Thyroid autoantibodies in thyroid cancer: Incidence and relationship with tumor outcome. Acta Endocrinol 1988;119:373–380. [DOI] [PubMed] [Google Scholar]

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