TY - JOUR
T1 - Clinical irrelevance of lower titer thyroglobulin autoantibodies in patients with differentiated thyroid carcinoma
AU - Dekker, Bernadette L
AU - van der Horst-Schrivers, Anouk N A
AU - Brouwers, Adrienne H
AU - Shuford, Christopher M
AU - Kema, Ido P
AU - Muller Kobold, Anneke C
AU - Links, Thera P
N1 - Funding Information:
Junior Scientific Masterclass Groningen (B L Dekker). The authors would like to thank H Breukelman, E Fransens, V D de Jager, F O W Muntinghe and A L M Schmidt of the Central Freezer Facility of the University Medical Center Groningen for their help.
Publisher Copyright:
© 2022 The authors Published by Bioscientifica Ltd.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - OBJECTIVE: Thyroglobulin(Tg) is an established tumor marker for differentiated thyroid carcinoma (DTC) patients. However, Tg immunoassays can be subject to Tg autoantibody(TgAb) interference resulting in incorrect Tg values. Therefore, Tg measurement with liquid chromatography-tandem mass spectrometry(LC-MS/MS) could be promising in patients with TgAbs. We compared a Tg immunoradiometric assay (Tg-IRMA) and a Tg-LC-MS/MS analytically in the presence of TgAbs. Furthermore, we compared the clinical interpretation of results obtained by both Tg assays in DTC patients with lower TgAbs titers (<10 U/ml) during 131I ablation therapy.METHODS: 118 DTC patients diagnosed between 2006 and 2014 in a University Medical Center were followed with the Tg-IRMA and ARCHITECT Anti-Tg assays. We re-analyzed their samples with a sensitive Tg-LC-MS/MS method (limit of quantification of 0.02 ng/ml). Passing-Bablok regression analysis was performed on samples obtained during 131I ablation therapy and follow-up.RESULTS: In 304 samples with lower TgAb titers, a good analytical agreement was found between both Tg assays (slope of 1.09 (95% CI 1.05 - 1.16)). Fifty-five samples with potentially interfering TgAbs showed higher Tg-LC-MS/MS values than Tg-IRMA (slope of 1.45 (95% CI 1.12->>100)). In patients (n=91) with lower TgAb titers at the time of 131I ablation therapy, the Tg assays showed a clinical concordance of 91.2%, 87.9%, and 98.9%, respectively, using a Tg cut-off value of 1.0 ng/mL, 2.0 ng/mL and 5.0 ng/mL.CONCLUSIONS: In DTC patients with lower titer TgAbs, Tg-IRMA is still a reliable and useful tumor marker. In DTC patients with potentially interfering TgAbs, Tg-IRMA values are decreased due to TgAb interference.
AB - OBJECTIVE: Thyroglobulin(Tg) is an established tumor marker for differentiated thyroid carcinoma (DTC) patients. However, Tg immunoassays can be subject to Tg autoantibody(TgAb) interference resulting in incorrect Tg values. Therefore, Tg measurement with liquid chromatography-tandem mass spectrometry(LC-MS/MS) could be promising in patients with TgAbs. We compared a Tg immunoradiometric assay (Tg-IRMA) and a Tg-LC-MS/MS analytically in the presence of TgAbs. Furthermore, we compared the clinical interpretation of results obtained by both Tg assays in DTC patients with lower TgAbs titers (<10 U/ml) during 131I ablation therapy.METHODS: 118 DTC patients diagnosed between 2006 and 2014 in a University Medical Center were followed with the Tg-IRMA and ARCHITECT Anti-Tg assays. We re-analyzed their samples with a sensitive Tg-LC-MS/MS method (limit of quantification of 0.02 ng/ml). Passing-Bablok regression analysis was performed on samples obtained during 131I ablation therapy and follow-up.RESULTS: In 304 samples with lower TgAb titers, a good analytical agreement was found between both Tg assays (slope of 1.09 (95% CI 1.05 - 1.16)). Fifty-five samples with potentially interfering TgAbs showed higher Tg-LC-MS/MS values than Tg-IRMA (slope of 1.45 (95% CI 1.12->>100)). In patients (n=91) with lower TgAb titers at the time of 131I ablation therapy, the Tg assays showed a clinical concordance of 91.2%, 87.9%, and 98.9%, respectively, using a Tg cut-off value of 1.0 ng/mL, 2.0 ng/mL and 5.0 ng/mL.CONCLUSIONS: In DTC patients with lower titer TgAbs, Tg-IRMA is still a reliable and useful tumor marker. In DTC patients with potentially interfering TgAbs, Tg-IRMA values are decreased due to TgAb interference.
U2 - 10.1530/etj-22-0137
DO - 10.1530/etj-22-0137
M3 - Article
C2 - 36169927
SN - 2235-0640
VL - 11
JO - European Thyroid Journal
JF - European Thyroid Journal
IS - 6
M1 - e220137
ER -