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Updated: Oct 11, 2025
Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
Published on: June 9, 2023
Markedly elevated serum preoperative thyroglobulin predicts radioiodine-refractory thyroid cancer
Xian Cheng1, Shichen Xu1, Yun Zhu1,2
1NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, China.
Background:
Repeated radiotherapy brings limited benefits and significant side effects for differentiated thyroid cancer patients (DTC) with radioiodine refractory (RAIR). However, the prognostic role of preoperative thyroglobulin (pre-Tg) in predicting RAIR is unclear.
Methods:
In the present study, data were retrospectively reviewed from 5173 patients who underwent radiotherapy in the Jiangyuan Hospital from January 2006 to December 2020.
Results:
A total of 1,102 patients with or without repeated radiotherapy were compared (repeated vs. single radiotherapy; n = 199 vs. n = 903). Pre-Tg was significantly elevated in patients with repeated radiotherapy. After the classification of RAIR (non-RAIR, n = 786 vs. RAIR, n = 90), elevated pre-Tg was also correlated with RAIR after univariate and multivariate analyses. According to the receiver operating characteristic curve analysis, elevated pre-Tg well predicted RAIR (AUC = 0.76, CI: 0.71-0.82, p < 0.0001). To control the selection bias, the propensity score matching was used. Pre-Tg level was found to be an independent predictor of RAIR (p < 0.001, HR = 7.25, CI: 2.55-20.62).
Conclusion:
Our results indicate that markedly elevated pre-Tg level can be served as an independent predictor of RAIR-DTC, which can guide a more precise treatment strategy and/or an active surveillance during surgery and follow-ups.
