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Differentiated thyroid cancer: Role of serum thyroglobulin

Author
R Michael Tuttle, MD
Section Editors
David S Cooper, MD
Douglas S Ross, MD
Deputy Editor
Jean E Mulder, MD

INTRODUCTION

Thyroglobulin (Tg) is a storage form of thyroxine (T4) and triiodothyronine (T3). It is synthesized only by thyroid follicular cells and released into serum along with the thyroid hormones. Given the cellular specificity of Tg, its detection in biopsy specimens provides proof of the thyroid origin of the tissue. In addition, measurements of serum Tg provide important information about the presence or absence of residual, recurrent, or metastatic disease in patients with differentiated thyroid cancer. This topic review will describe the methods for measuring serum Tg and the use of serum Tg measurements in patients with differentiated thyroid cancer. Other aspects of the management of thyroid cancer are reviewed separately. (See "Differentiated thyroid cancer: Overview of management".)

THYROGLOBULIN ASSAY

Testing of serum thyroglobulin (Tg) should be done using a sensitive assay, ideally using the same assay for each sample.

Methodology — Serum Tg is now generally measured by two-antibody “sandwich” immunometric assays (the antigen is sandwiched between the two antibodies) in which the capture antibody is bound to a solid support and the detection antibody is labeled with either an isotopic (immunoradiometric assay, IRMA) or non-isotopic (usually immuno-chemiluminescent assay, ICMA) marker. The values in normal subjects in most laboratories range from 1 to about 30 ng/mL. These immunometric assays are quicker, readily automated, and have greater sensitivity (0.1 to 1 ng/mL) than most radioimmunoassays [1].

Interassay variation — Despite a trend toward assay standardization, serum Tg values obtained with different assays cannot be directly compared, as interassay variability remains substantial [2-4]. The variability in assay results is due to [1,5-7]:

Variations in the anti-Tg antibodies used.

             

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Literature review current through: Nov 2016. | This topic last updated: Mon Nov 09 00:00:00 GMT 2015.
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