Thyroglobulin and thyroglobulin antibody: an updated clinical and laboratory expert consensus
Luca Giovanella, Federica D’Aurizio, Alicia Algeciras‐Schimnich, Rainer Görges, Petra Petranović Ovčariček, R. Michael Tuttle, W. Edward Visser, Frederik A. Verburg, hsTg&TgAb Consensus Working Group, Martyna Borowczyk, Luca Chiovato, Leonidas H. Duntas, Thyroid Section, Ulla Feldt‐Rasmussen, Luisa Knappe, Laurence Leenhardt, Flavia Magri, Harald Rimmele, Ettore Seregni
Abstract
OBJECTIVE: Thyroglobulin measurement is the cornerstone of modern management of differentiated thyroid cancer, with clinical decisions on treatment and follow-up based on the results of such measurements. However, numerous factors need to be considered regarding measurement with and interpretation of thyroglobulin assay results. DESIGN: The present document provides an integrated update to the 2013 and 2014 separate clinical position papers of our group on these issues. METHODS: Issues concerning analytical and clinical aspects of highly-sensitive thyroglobulin measurement will be reviewed and discussed based on an extensive analysis of the available literature. RESULTS: Thyroglobulin measurement remains a highly complex process with many pitfalls and major sources of interference, especially anti-thyroglobulin antibodies, need to be assessed, considered and, when necessary, dealt with appropriately. CONCLUSIONS: Our expert consensus group formulated 53 practical, graded recommendations for guidance on highly-sensitive thyroglobulin and TgAb in laboratory and clinical practice, especially valuable where current guidelines do not offer sufficient guidance.