Pre-Operative Antithyroid Antibodies in Differentiated Thyroid Cancer

Objective: To evaluate the significance of antithyroglobulin and antithyroid peroxidase antibody levels associated with locoregional metastatic disease in patients with well-differentiated thyroid cancer. Methods: Patients underwent initial treatment for well-differentiated thyroid cancer at our institution between 2014 and 2018. The following variables were collected: age, sex, pre-operative thyroid -stimulating hormone, thyroglobulin, antithyroglobulin antibody (TgAb), antithyroid peroxidase antibody (TPOAb), the extent of surgery, T-stage, N-stage, extrathyroidal extension (ETE), extranodal extension (ENE), lymphovascular invasion, and multifocal disease. The relationships between disease status and pre-operative TPOAb, TgAb, thyroglobulin, and thyroid-stimulating hormone were analyzed. Results: A total of 405 patients (mean age, 52 years) were included in the study, of which 66.4% were women. Elevated TgAb was associated with the presence of lymph node metastases (LNM) in both the central and lateral neck (P .01), with a stronger correlation to N1b versus N1a disease (P = .03). The presence of ETE was inversely related to the TgAb titer (P = .03). TPOAb was associated with a lower T-stage (P = .04), fewer LNM (P = .04), and a lower likelihood of ETE (P = .02). From multivariable analysis, TgAb .01). TPOAb 60 IU/mL was associated with a lower T-stage (P =.04 for T <3) and absence of ETE (P = .01). Conclusion: Elevated pre-operative TgAb was an independent predictor of nodal metastases and ENE, while elevated TPOAb was associated with a lower pathologic T-and N-stage. Pre-operative antithyroid antibody titers may be useful to inform the disease extent and features. (c) 2021 AACE. Published by Elsevier Inc. All rights reserved.

Automated summary

This study aimed to evaluate the significance of antithyroglobulin and antithyroid peroxidase antibody levels in patients with well-differentiated thyroid cancer. Results showed that elevated TgAb levels were associated with nodal metastases and ENE, while elevated TPOAb levels were correlated with lower T and N stages.