Revisiting Thyroglobulin Measurement: Current Methods and Future Perspectives Using Dried Blood Spot Sampling for...

Area of Science:

• Endocrinology
• Clinical Chemistry
• Analytical Chemistry

Background:

• Human thyroglobulin (Tg) is a key serum biomarker for differentiated thyroid carcinoma (DTC) recurrence post-thyroidectomy.
• Current immunoassays (IMAs) and radioimmunoassays (RIAs) for Tg measurement are susceptible to interference from anti-thyroglobulin antibodies (Tg-Abs) and heterophile antibodies (HAs).
• This interference can lead to inaccurate Tg concentration estimations, impacting patient management.

Purpose of the Study:

• To review current follow-up protocols for thyroglobulin (Tg) quantification in DTC patients.
• To evaluate the potential of mass spectrometry (MS) techniques for Tg analysis.
• To introduce and highlight the translational potential of a novel approach combining dried blood spots (DBSs) with LC-MS/MS for DTC patient follow-up.

Main Methods:

• Review of existing literature on Tg quantification methods for DTC follow-up.
• Evaluation of liquid chromatography tandem mass spectrometry (LC-MS/MS) as a Tg measurement tool.
• Exploration of the combined dried blood spot (DBS) and LC-MS/MS approach for Tg analysis.

Main Results:

• Immunoassays and radioimmunoassays for Tg are prone to significant interference, affecting accuracy.
• Liquid chromatography tandem mass spectrometry (LC-MS/MS) presents a more specific and reliable method for Tg quantification.
• The combination of DBS with LC-MS/MS shows promise for simplified and accurate Tg monitoring.

Conclusions:

• Interference in current Tg assays necessitates more reliable methods for DTC follow-up.
• Mass spectrometry, particularly LC-MS/MS, offers improved accuracy in Tg measurements.
• The integration of dried blood spots with LC-MS/MS holds significant potential for enhancing the clinical management of differentiated thyroid carcinoma patients.