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Accuracy of unstimulated Basal serum thyroglobulin levels in assessing the completeness of thyroidectomy.

Gurleyik E, Dogan S - J Clin Med Res (2014)

Bottom Line: Complete excision is important for proper surgical treatment of thyroid disorders.In 77 patients with negative scan, the Tg levels were also negative (true negative), and the PPV, NPV, sensitivity, specificity and accuracy of the Tg levels were 100%, 92%, 70%, 100% and 93%, respectively.The negative Tg (< 0.5 ng/mL) level supported complete excision of the thyroid gland.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Faculty of Medicine, Duzce University, Duzce, Turkey.

ABSTRACT

Background: Complete excision is important for proper surgical treatment of thyroid disorders. Functional thyroid tissue can be identified based on the level of serum thyroglobulin (Tg), which is produced only by the thyroid follicular cells, and nuclear scan.

Methods: Serum thyroid stimulating hormone (TSH), free thyroxin (FT4), basal (unstimulated) Tg and anti-Tg antibody (anti-Tg ab) were measured at the sixth postoperative month in 100 patients with benign thyroid disorders treated by total thyroidectomy. Thyroid nuclear scan was obtained to identify functional remnant of the thyroid gland. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the Tg levels in assessing thyroid remnant were calculated.

Results: Positive scan showed thyroid remnant in 23 patients, among whom 16 were Tg positive (true positive) and seven were Tg negative (< 0.5 ng/mL) (false negative). In these patients, the nuclear scan revealed pyramidal lobe remnants. In 77 patients with negative scan, the Tg levels were also negative (true negative), and the PPV, NPV, sensitivity, specificity and accuracy of the Tg levels were 100%, 92%, 70%, 100% and 93%, respectively.

Conclusions: The positive basal Tg (> 0.5 ng/mL) level accurately indicated the functional thyroid remnant after total thyroidectomy. The negative Tg (< 0.5 ng/mL) level supported complete excision of the thyroid gland. The surgical completeness of total thyroidectomy was accurately evaluated based on the serum Tg levels. Therefore, serum Tg levels should be measured in postoperative follow-up to determine the completeness of total thyroidectomy.

No MeSH data available.


Related in: MedlinePlus

Remnant of thin pyramidal lobe. Nuclear scan and Tg positive (2.7 ng/mL); true positive.
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Figure 1: Remnant of thin pyramidal lobe. Nuclear scan and Tg positive (2.7 ng/mL); true positive.

Mentions: A total of 73 patients were women with a mean age of 54 years (range, 33 - 71 years). The serum Tg levels were negative (< 0.5 ng/mL) in all the 77 patients who had no functional remnant of the thyroid gland (negative nuclear scan; true negative). Postoperative nuclear scan of the gland showed small thyroid remnants in 23 patients. The thyroid remnant was present (positive nuclear scan) in all 16 patients with positive Tg levels (true positive). However, the serum Tg levels were also negative in seven (of 23) patients with positive nuclear scan (false negative in 7% of the patients) (Table 1). In the positive nuclear scan cases, the focal uptake of the radionuclide was determined in the midline, which indicated pyramidal lobe (PL) remnant (Fig. 1-3).


Accuracy of unstimulated Basal serum thyroglobulin levels in assessing the completeness of thyroidectomy.

Gurleyik E, Dogan S - J Clin Med Res (2014)

Remnant of thin pyramidal lobe. Nuclear scan and Tg positive (2.7 ng/mL); true positive.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4125332&req=5

Figure 1: Remnant of thin pyramidal lobe. Nuclear scan and Tg positive (2.7 ng/mL); true positive.
Mentions: A total of 73 patients were women with a mean age of 54 years (range, 33 - 71 years). The serum Tg levels were negative (< 0.5 ng/mL) in all the 77 patients who had no functional remnant of the thyroid gland (negative nuclear scan; true negative). Postoperative nuclear scan of the gland showed small thyroid remnants in 23 patients. The thyroid remnant was present (positive nuclear scan) in all 16 patients with positive Tg levels (true positive). However, the serum Tg levels were also negative in seven (of 23) patients with positive nuclear scan (false negative in 7% of the patients) (Table 1). In the positive nuclear scan cases, the focal uptake of the radionuclide was determined in the midline, which indicated pyramidal lobe (PL) remnant (Fig. 1-3).

Bottom Line: Complete excision is important for proper surgical treatment of thyroid disorders.In 77 patients with negative scan, the Tg levels were also negative (true negative), and the PPV, NPV, sensitivity, specificity and accuracy of the Tg levels were 100%, 92%, 70%, 100% and 93%, respectively.The negative Tg (< 0.5 ng/mL) level supported complete excision of the thyroid gland.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Faculty of Medicine, Duzce University, Duzce, Turkey.

ABSTRACT

Background: Complete excision is important for proper surgical treatment of thyroid disorders. Functional thyroid tissue can be identified based on the level of serum thyroglobulin (Tg), which is produced only by the thyroid follicular cells, and nuclear scan.

Methods: Serum thyroid stimulating hormone (TSH), free thyroxin (FT4), basal (unstimulated) Tg and anti-Tg antibody (anti-Tg ab) were measured at the sixth postoperative month in 100 patients with benign thyroid disorders treated by total thyroidectomy. Thyroid nuclear scan was obtained to identify functional remnant of the thyroid gland. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the Tg levels in assessing thyroid remnant were calculated.

Results: Positive scan showed thyroid remnant in 23 patients, among whom 16 were Tg positive (true positive) and seven were Tg negative (< 0.5 ng/mL) (false negative). In these patients, the nuclear scan revealed pyramidal lobe remnants. In 77 patients with negative scan, the Tg levels were also negative (true negative), and the PPV, NPV, sensitivity, specificity and accuracy of the Tg levels were 100%, 92%, 70%, 100% and 93%, respectively.

Conclusions: The positive basal Tg (> 0.5 ng/mL) level accurately indicated the functional thyroid remnant after total thyroidectomy. The negative Tg (< 0.5 ng/mL) level supported complete excision of the thyroid gland. The surgical completeness of total thyroidectomy was accurately evaluated based on the serum Tg levels. Therefore, serum Tg levels should be measured in postoperative follow-up to determine the completeness of total thyroidectomy.

No MeSH data available.


Related in: MedlinePlus