Cáncer diferenciados de tiroides : niveles de tiroglobulina pre ablación con yodo radioactivo y respuesta terapéutica
Fecha
2018
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Introducción: La tiroglobulina es un excelente marcador de persistencia o recurrencia del cáncer diferenciado de tiroides, su rol como valor pronóstico no está plenamente determinado. Objetivo: correlacionar el nivel de tiroglobulina pre-ablación con yodo radiactivo y la respuesta terapéutica a corto plazo en pacientes con cáncer diferenciado de tiroides en el hospital “Teodoro Maldonado Carbo”, período 2016-2017. Metodología: Es de diseño observacional, analítico, de cohorte. Resultados: A Los 6 meses el 29.3% de los casos presentaron persistencia bioquímica; de los cuales el 68% tenían tiroglobulina pre-ablación >10 ng/dL. Hacia los 12 meses post-ablación, el 30.7% presentaron persistencia bioquímica; de los cuales 63% con tiroglobulina pre-ablación >10 ng/dL. El 2% presentó recidiva, entre 6 a 12 meses post-ablación. Se estimó un valor de corte óptimo de tiroglobulina pre-ablación >14.4 ng/dL, para el diagnóstico de persistencia bioquímica tanto a 6 como a 12 meses post-ablación, el valor de tiroglobulina ya sea a 10 ng/mL o 14 ng/mL tenía similar suficiencia diagnostica de persistencia a 6 meses post-ablación. La mediana de tiroglobulina disminuyó desde un nivel pre-ablación de 5.6 ng/dL hacia 0.28 ng/dL a los 6 meses (p<0.001) y 0.3 ng/dL a los 12 meses (p<0.001). Conclusión: La determinación de la tiroglobulina pre-ablación es útil, como marcador pronóstico de la recidiva o persistencia del cáncer diferenciado de tiroides a corto plazo.
Introduction: Thyroglobulin is an excellent marker of persistence or recurrence of differentiated thyroid cancer, its role as a progn ostic value is not fully determined. Objective: to correlate the level of thyroglobulin pre-ablation with radioactive iodine and the short-term therapeutic response in patients with differentiated thyroid cancer at “Teodoro Maldonado Carbo” hospital, 2016-2017 period. Methodology: It is an observational, analytical, cohort design. Results: At 6 months, 29.3% of the cases presented biochemical persistence; of which 68% had thyroglobulin pre-ablation> 10 ng / dL. By 12 months post-ablation, 30.7% had biochemical persistence; of which 63% with pre-ablation thyroglobulin> 10 ng / dL. 2% had recurrence, between 6 to 12 months post-ablation. An optimal cut-off value of thyroglobulin pre-ablation> 14.4 ng / dL was estimated, for the diagnosis of biochemical persistence both at 6 and 12 months post-ablation, the value of thyroglobulin either at 10 ng / mL or 14 ng / mL had similar diagnostic sufficiency of persistence at 6 months post-ablation. The median thyroglobulin decreased from a pre-ablation level of 5.6 ng / dL to 0.28 ng / dL at 6 months (p <0.001) and 0.3 ng / dL at 12 months (p <0.001). Conclusion: The determination of pre-ablation thyroglobulin is useful as a prognostic marker of recurrence or persistence of differentiated thyroid cancer in the short term.
Introduction: Thyroglobulin is an excellent marker of persistence or recurrence of differentiated thyroid cancer, its role as a progn ostic value is not fully determined. Objective: to correlate the level of thyroglobulin pre-ablation with radioactive iodine and the short-term therapeutic response in patients with differentiated thyroid cancer at “Teodoro Maldonado Carbo” hospital, 2016-2017 period. Methodology: It is an observational, analytical, cohort design. Results: At 6 months, 29.3% of the cases presented biochemical persistence; of which 68% had thyroglobulin pre-ablation> 10 ng / dL. By 12 months post-ablation, 30.7% had biochemical persistence; of which 63% with pre-ablation thyroglobulin> 10 ng / dL. 2% had recurrence, between 6 to 12 months post-ablation. An optimal cut-off value of thyroglobulin pre-ablation> 14.4 ng / dL was estimated, for the diagnosis of biochemical persistence both at 6 and 12 months post-ablation, the value of thyroglobulin either at 10 ng / mL or 14 ng / mL had similar diagnostic sufficiency of persistence at 6 months post-ablation. The median thyroglobulin decreased from a pre-ablation level of 5.6 ng / dL to 0.28 ng / dL at 6 months (p <0.001) and 0.3 ng / dL at 12 months (p <0.001). Conclusion: The determination of pre-ablation thyroglobulin is useful as a prognostic marker of recurrence or persistence of differentiated thyroid cancer in the short term.
Descripción
PDF
Palabras clave
Neoplasias de la tiroides, Tiroglobulina, Ablación, Yodo radiactivo, Pronóstico, Endocrinología, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador