Related Experiment Video
Updated: May 12, 2026
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Predictive value of preoperative serum thyroglobulin and anti-thyroglobulin antibodies for central compartment lymph
Xi Lin1, Fangfang Wang1, Xiaoliang Chen2
1Department of Thyroid and Breast Surgery, Tiantai People's Hospital of Zhejiang Province (Tiantai Branch of Zhejiang Provincial People's Hospital), Taizhou, Zhejiang, China.
Objective:
To investigate the predictive value of preoperative serum thyroglobulin (Tg) and anti-thyroglobulin antibodies (TgAb) for central compartment lymph node metastasis (CLNM) in patients with clinically node-negative (cN0) papillary thyroid carcinoma (PTC).
Methods:
A retrospective analysis was conducted on clinical data from patients with cN0 PTC who underwent total thyroidectomy with central compartment lymph node dissection at our hospital between January 2018 and December 2023. Patients were randomly divided into a training cohort and a validation cohort in a 7:3 ratio. Data collected included patient demographics, clinicopathological characteristics, and preoperative serum Tg and TgAb levels. The outcome measure was pathologically confirmed CLNM status. Univariate and multivariate logistic regression analyses were employed to identify independent predictors of CLNM. The predictive value of preoperative serum Tg, TgAb, and the constructed prediction model for CLNM was assessed using receiver operating characteristic (ROC) curve analysis.
Results:
A total of 790 patients were enrolled in this study, comprising 553 in the training cohort and 237 in the validation cohort. The overall incidence of CLNM was 37.7% (298/790). In the training cohort, preoperative serum Tg and TgAb levels were significantly higher in the CLNM group compared to the non-CLNM group (P < 0.05). Multivariate logistic regression analysis identified age <45 years (OR = 1.675), maximal tumor diameter ≥1 cm (OR = 2.348), capsular invasion (OR = 2.757), preoperative serum Tg ≥ 34.7 ng/mL (OR = 2.257), preoperative serum TgAb ≥62.6 IU/mL (OR = 1.796), and log10 (Tg/TgAb +1) ≥ 0.21 (OR = 2.409) as independent predictors of CLNM (P < 0.05). The prediction model incorporating these six factors yielded AUCs of 0.863 and 0.819 for predicting CLNM in the training and validation cohorts, respectively.
Conclusion:
Preoperative serum Tg and TgAb are independent predictors of CLNM in cN0 PTC patients. The prediction model, which combined these serological markers with clinicopathological characteristics demonstrates good predictive performance and may offer valuable guidance for clinical decision-making regarding the necessity of prophylactic central compartment lymph node dissection in cN0 PTC patients.
