The Utility of Serum Anti-thyroglobulin Antibody and Thyroglobulin in the Preoperative Differential Diagnosis of Thyroid Follicular Neoplasm

Abstract PurposeIt is challenging to distinguish follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA) before surgery due to the lack of malignant ultrasound features, the underdiagnosis by fine-needle biopsy, and the absence of definitive markers. We investigated whether thyroglobulin (Tg), anti-thyroglobulin antibody (TgAb), thyroid peroxidase antibodies (TPOAb), and thyroid stimulating hormone (TSH) could help differentiate FTC from FTA.MethodsA total of 319 patients with follicular neoplasms were included. We analyzed the serum markers as continuous and categorical variables between FTC and FTA. Also, we analyzed the prevalence of FTC in different serum markers groups.ResultsThe TgAb was a risk factor of FTC. Versus the TgAb group (≤11.68 IU/mL), OR of the group (11.69-30.50 IU/mL) and the group (＞30.50 IU/mL) were 2.206 (1.114-4.369, P=0.023) and 3.247 (1.684-6.260, P＜0.001), respectively. Versus the TgAb group (≤11.68 IU/mL), the malignant prevalence of the group (＞30.50 IU/mL) was higher (13.1% vs. 32.9%, P=0.001). In TgAb (-) patients, the Tg was another risk factor of FTC. Versus the Tg group (≤38.51 ng/mL), OR of the group (＞434.60 ng/mL) was 3.836 (1.625-9.058, P=0.002); the malignant prevalence of the group (＞434.60 ng/mL) was 47.2% and higher than other groups.ConclusionsThe TgAb and Tg may have utility in the preoperative differential diagnosis of follicular neoplasm. The higher TgAb and Tg were associated with higher malignant risk. Thus, we should be cautious of preoperative TgAb and Tg in follicular neoplasm.