Endocrinology Research and Practice
Original Articles

A New Perspective on Anti-Thyroglobulin Antibody Patterns in the Follow-Up of Papillary Thyroid Carcinoma

1.

Department of Endocrinology and Metabolism, Ankara Gülhane Research and Training Hospital, Health Sciences University, Ankara, Türkiye

2.

Department of Endocrinology and Metabolism, Sincan Training and Research Hospital, Ankara, Türkiye

Endocrinol Res Pract 2025; 29: 320-326
DOI: 10.5152/erp.2025.25767
Read: 93 Downloads: 39 Published: 08 October 2025

Objective: This study aimed to describe distinct anti-thyroglobulin antibody (TgAb) trend trends and assess their association with clinical outcomes in papillary thyroid carcinoma (PTC).

Methods: Twenty-two PTC patients with TgAb positivity (at diagnosis, postoperative follow-up, or post-Radioidoine (RAI) were retrospectively analyzed, classified into classical (declining/stable/ increasing) and nonclassical trend groups, and their clinical and outcome data was reviewed.

Results: Classical TgAb patterns were observed in 14 patients (63.6%), including 12 with a declining pattern (median time to seronegativity: 20 months, range: 12-48) and 2 with persistently stable positivity. Among those with decreasing TgAb, 2 patients had previously experienced structural recurrence, both accompanied by transient TgAb rises. In the stable subgroup, 1 patient had persistent but subcentimetric nodal disease without progression. Nonclassical patterns were identified in 8 patients (36.4%), distributed across 4 distinct scenarios: (1) Persistently very high TgAb remaining undetectable without structural disease (n=2), lasting ≥3 years, (2) transient de novo TgAb positivity following radioiodine treatment (RAIT) (n=2), with spontaneous decline to negativity within 12-18 months, (3) late-onset de novo TgAb after RAIT, remaining stable without structural disease (n=2), remaining stable (up to 5 years) without evidence of disease, (4) de novo TgAb rising with recurrence (n=2), 1 presenting with nodal relapse and the other with pulmonary metastases, both showing TgAb decline after treatment.

Conclusion: In PTC follow-up, TgAb trends were more informative than absolute levels: transient elevations and de novo stable or persistently stable TgAb were less likely to indicate structural disease, whereas de novo rising TgAb strongly suggested recurrence. However, given the small, single-center cohort and retrospective design, these findings require confirmation in larger prospective studies.

Cite this article as: Bahçecioğlu AB, Erdem M. A new perspective on antithyroglobulin antibody patterns in the follow-up of papillary thyroid carcinoma. Endocrinol Res Pract. 2025;29(4):320-326.

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