Published online Feb 26, 2017. doi: 10.4331/wjbc.v8.i1.81
Peer-review started: October 7, 2016
First decision: November 10, 2016
Revised: December 28, 2016
Accepted: January 11, 2017
Article in press: January 14, 2017
Published online: February 26, 2017
Processing time: 149 Days and 15.7 Hours
It is worthwhile to measure serum thyroglobulin (TG) level in thyroid cancer before subjecting patients to surgery for two reasons. Firstly, if the level is high, it may give a clue to the local and metastatic tumour burden at presentation; secondly, if the level is normal, it identifies the patients who are unlikely to show rising TG levels in the presence of thyroid cancer. Those who have high serum TG before surgery will show up recurrence as rising serum TG during the postoperative period. Those who do not have high serum TG before surgery will not show up rising serum TG in the presence of recurrent disease. In the latter situation, normal TG level gives only a false reassurance regarding recurrence of disease. Nevertheless, rising serum TG during the postoperative period must be interpreted cautiously because this could be due to the enlargement of non-cancerous residual thyroid tissue inadvertently left behind during surgery.
Core tip: Although serum thyroglobulin (TG) is widely used as a tool to detect recurrence of thyroid cancer, it is widely held that preoperative TG measurement is unnecessary. It is true that preoperative TG level is hardly of much diagnostic value, but without a preoperative TG report, it is not possible to safely utilize serial serum TG subsequently as a monitoring tool. Routine measurement of serum TG before surgery is, therefore, recommended.