Zhonghua Yi Xue Za Zhi. 2026 Mar 10;106(9):828-833. doi: 10.3760/cma.j.cn112137-20250810-02022.
ABSTRACT
Objective: To explore the relationship between preoperative thyroglobulin (Tg) levels and recurrence risk as well as treatment response in patients with differentiated thyroid cancer (DTC). Methods: A retrospective analysis was conducted on the clinical data of 604 patients with DTC who underwent total thyroidectomy at Shanghai Renji Hospital from January 1, 2020, to December 31, 2024. The postoperative recurrence status of patients was recorded, with follow-up ending on June 30, 2025. Determine the cut-off value of preoperative Tg for predicting patient prognosis using the maximum selected rank statistic method. Multivariate Cox proportional hazards regression model was used to analyze the risk factors for postoperative recurrence in DTC patients. Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was used to evaluate the differences in postoperative disease-free survival rates and treatment response among DTC patients with different preoperative Tg levels. Results: Among the 604 patients, 417 were female and 187 were male, with the age of 45.0(36.0, 57.0) years. The preoperative Tg was 20.2 (10.4, 44.3) μg/L, and the follow-up period was 1.40 (0.85, 2.84) years. Multivariate Cox proportional hazards regression model analysis revealed that preoperative Tg levels≥36.2 μg/L (HR=14.180, 95%CI:1.745-115.200) was a risk factor for postoperative recurrence in DTC. Patients with the preoperative Tg level of<36.2 μg/L had a higher 3-year disease-free survival rate compared to those with the preoperative Tg level of≥36.2 μg/L (99.8% vs 92.3%, P<0.001). The proportion of patients with the favorable treatment response was lower among those with the preoperative Tg level of≥36.2 μg/L compared to those with the preoperative Tg level of<36.2 μg/L, whereas the proportions of patients with biochemical incomplete, structural incomplete, and indeterminate responses were higher among those with the preoperative Tg level of≥36.2 μg/L (all P<0.05). Conclusions: Preoperative Tg levels are significantly associated with the recurrence risk and treatment response in DTC patients. The Tg level of≥36.2 μg/mL indicates a high recurrence risk and poor treatment response.
PMID:41796005 | DOI:10.3760/cma.j.cn112137-20250810-02022
