Is it possible to predict hypothyroidism after thyroid lobectomy through thyrotropin, thyroglobulin, anti-thyroglobulin, and anti-microsomal antibody?
조진성, 신선형, 송영주, 김희경, 박민호, 윤정한, 제갈영종,
소속 상세정보
조진성 ( Cho Jin-Seong )
Chonnam National University Medical School Department of Surgery
신선형 ( Shin Sun-Hyoung )
Chonnam National University Medical School Department of Surgery
송영주 ( Song Young-Ju )
Chonnam National University Medical School Department of Surgery
김희경 ( Kim Hee-Kyung )
Chonnam National University College of Medicine Department of Internal Medicine
박민호 ( Park Min-Ho )
Chonnam National University Medical School Department of Surgery
윤정한 ( Yoon Jung-Han )
Chonnam National University Medical School Department of Surgery
제갈영종 ( Jegal Young-Jong )
Chonnam National University Medical School Department of Surgery
KMID : 0371320110810060380
Abstract
Purpose: We investigated the incidence and risk factors of hypothyroidism after thyroid lobectomy, and evaluated the possibility to predict hypothyroidism preoperatively with serologic markers, such as thyrotropin (TSH), thyroglobulin (TG), anti-thyroglobulin (ATA), and anti-microsomal antibody (AMA).
Methods: We enrolled 123 consecutive patients who underwent thyroid lobectomy due to benign conditions between May 2004 and April 2008. Only preoperative euthyroid patients were included. Patients were divided into two groups by postoperative thyroid function outcomes, into hypothyroid (n = 97) and euthyroid groups (n = 26), and analyzed specially for the preoperative levels of TSH, TG, ATA, and AMA.
Results: Twenty-six (21.1%) patients developed hypothyroidism following thyroid lobectomy within 35.7 months of follow-up. The proportion of post-lobectomy hypothyroidism was high in patients with high-normal preoperative TSH level, and the cut-off value was 2.0 mIU/L, with 67% sensitivity and 75% specificity. The quantitative titer of preoperative TG, ATA, and AMA was not significant, but the outcome of categorical analysis of two or more positivities on these three markers was significantly higher in hypothyroid patients than in euthyroid patients (28.6% vs. 3.9%, P = 0.024). The combined positivity of preoperative TSH and two or more positivities of TG, ATA, and AMA possess 100% positive predictive value and 81% negative predictive value.
Conclusion: The incidence of hypothyroidism following thyroid lobectomy was 21.1%. High-normal preoperative TSH and two or more positivities for TG, ATA, and AMA are good pre-operative predictive markers. Such high-risk patients need close TSH monitoring before the onset of clinical hypothyroidism.
키워드
Hypothyroidism; Thyrotropin; Thyroglobulin; Thyroid microsomal antibodies
원문 및 링크아웃 정보
등재저널 정보