VALUE OF SERUM THYROGLOBULIN MEASUREMENT IN PATIENTS OPERATED ON FOR WELL-DIFFERENTIATED THYROID-CARCINOMA

Objective: To study the clinical relevance of measurements of serum th yroglobulin in patients undergoing total thyroidectomy for well differ entiated thyroid cancer. Design: Prospective study. Setting: Universit y hospital, Sweden. Subjects: 194 patients operated on for well differ entiated thyroid cancer from 1 January 1978 to 31 December 1992. Inter ventions: All patients underwent total thyroidectomy by a standard tec hnique, and were prospectively followed up at regular intervals by cli nical examination and measurement of the serum thyroglobulin concentra tion. Results: Six patients whose thyroglobulin concentrations after o peration were low or undetectable had gradual increases leading to det ection of recurrences that could be treated successfully. Six patients had gradual increases without detectable recurrences. In 12 patients thyroglobulin concentrations remained high after operation with no sig ns of thyroid tissue remaining, which we interpreted as persistence of the disease. No recurrence was found without an appreciable rise in t he thyroglobulin concentration. Thyroglobulin antibodies were found in 81 (42%). Conclusion: Measurement of the serum thyroglobulin concentr ation is a valuable addition to the follow up of patients operated on for highly differentiated thyroid cancer. In many cases it is the firs t sign of recurrent disease, thereby facilitating early and successful treatment.