Eur Thyroid J. 2023 Apr 1:ETJ-22-0219. doi: 10.1530/ETJ-22-0219. Online ahead of print.
ABSTRACT
BACKGROUND: Purpose To determine whether thyroid stimulating hormone level ≥30 mU/l is necessary for radioiodine (131I) remnant ablation (RRA) in patients with differentiated thyroid cancer (DTC), as well as its influencing factors and predictors.
METHODS: 487 DTC patients were retrospectively enrolled in this study. They were divided into two groups (TSH <30 and ≥30 mU/l) and further divided into eight subgroups (0-<30, 30-<40, 40-<50, 50-<60, 60-<70, 70-<80, 80-<90, 90-<100 mU/l). The simultaneous serum lipids level, successful rate of RRA and its influencing factors in different groups were analyzed. The receiver operating characteristic curves derived from pre-ablative thyroglobulin (pre-Tg) and pre-Tg/TSH ratio were compared for RRA success prediction performance.
RESULTS: There was no statistical difference in success rates of RRA between the two groups (p=0.247) and eight subgroups (p=0.685). Levels of total cholesterol (p<0.001), triglyceride (p=0.006), high-density lipoprotein cholesterol (p=0.024), low-density lipoprotein cholesterol (p=0.001), apolipoprotein B (p<0.001) and apolipoprotein E (p=0.002) were significantly higher while apoA/apoB ratio (p=0.024) were significantly lower at TSH ≥30 mU/l group. Pre-Tg level, gender and N stage were influencing factors for RRA. The area under the curve of pre-Tg level and pre-Tg/TSH ratio were 0.7611 (p<0.0001), 0.7340 (p<0.0001) for all enrolled patients and 0.7310 (p=0.0145), 0.6524 (p=0.1068) for TSH <30 mU/l respectively.
CONCLUSION: TSH ≥30 mU/l may not be necessary for the success of RRA. Patients with higher serum TSH level prior RRA will suffer from severer hyperlipidemia. Pre-Tg level could be used as a predictor for the success of RRA, especially when TSH <30 mU/l.
PMID:37022724 | DOI:10.1530/ETJ-22-0219
