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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Biomarkers, Clinical Decision-Making, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Outcome Assessment (Health Care), Patient Selection, Positron-Emission Tomography, Recurrence, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Thyroglobulin, Thyroid Neoplasms, Whole Body Imaging.
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Do stimulated high serum thyroglobulin with negative whole body imaging warrant an aggressive diagnostic and therapeutic approach in differentiated thyroid cancer patients : A follow-up of 5 years or till recurrence? Context: To study the clinical significance of stimulated high serum thyroglobulin (sTg) and of normal whole body imaging (WBI) in differentiated thyroid cancer (DTC) patients during their first follow-up and in a 5 years follow-up or till recurrence. Sixty four DTC patients were retrospectively studied and were divided into two groups. Group 1, of 35 patients with disease free status on their first follow-up and group 2, of 29 patients with high sTg (>2 μg/mL), but with normal WBI, iodine-131 (¹³¹I) findings. Patients were categorized into low, intermediate and high risk patients based on the ¹³¹I WBS findings. Histology, stage and risk-categories of both groups were statistically correlated. Best sTg cut-off for predicting recurrence was generated by receiver operating characteristic (ROC). Odd ratio for sTg trend was also analyzed for risk of recurrence in group 2. Independent t test was used for progression free survival (PFS) comparison of the two groups. No statistical differences were seen in histology, stage and risk category distributions between the groups. Group 2 patients with high sTg (range 2.5-81 μg/L, mean 20.5 μg/L) on their first follow-up had higher risk of recurrence (odd ratio 4.304) but P value was insignificant (P:0.090). Eighty six per cent of group 2 patients showed decreasing trends and in 62% of group 2 patients, high serum sTg fell to normal. Indeed, decreasing trends of sTg reduced the risk of recurrence (odd ratio 1.3939, P:0.79). Analysis by ROC showed that sTg>11 μg/L was the best cut-off in predicting recurrence with sensitivity 100% and specificity 56%. High sTg was not associated with low PFS, (P:0.232), however patients with increasing sTg had significantly shorter PFS (P<0.005).
assistant
High sTg with negative ¹³¹I WBS did not warrant an aggressive DTC disease. These patients in their 5 years or till recurrence follow-up showed downward trends of serum sTg, no higher risk or recurrence and no shorter PFS. Final Decision: no