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Original Article
Diagnostic Value of Preoperative Serum Thyroglobulin Measurement for the Diagnosis of Malignancy in Follicular or Hürthle Cell Neoplasms of the Thyroid Gland
Nam Kyu Kim, Seong Joo Kang, Weon Hyoung Lee, Go Eun Yeo, You Jin Han, Bu Kyung Kim, Su Kyoung Kwon, Yo-Han Park, Young Sik Choi
Kosin Medical Journal 2014;29(1):17-22.
Published online: December 17, 2014

Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: Young Sik Choi, Department of Internal Medicine, Kosin University College of Medicine, 34 Amnam dong, Seo-gu, Busan 602-702, Korea TEL: +82-51-990-6102 FAX: +82-51-248-5686 E-mail:
• Received: June 4, 2013   • Revised: August 20, 2013   • Accepted: September 9, 2013

Copyright © 2014 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    The aim of this retrospective study was whether serum Tg predicts malignancy in follicular or Hürthle-cell neoplasms on fine needle aspiration.
  • Methods
    A chart review of 111 patients (90 females, 21 males; mean age 46.8 ± 11.9 years) with follicular or Hürthle-cell neoplasms on fine needle aspiration, who were surgically treated between Sep. 2001 and Sep. 2011, was performed. Predictive factors for malignancy were identified by the chi-squared test and multivariate logistic regression.
  • Results
    There were no differences between 41 malignant and 70 benign lesions in serum Tg or any of the normalized indexes. Receiver-operator characteristic analysis revealed no cutoff value. Lesions with serum Tg levels greater than 500 g/L had no significant difference. And also there were no independent predictors of malignancy by multivariate logistic regression.
  • Conclusions
    In this study, the author found that serum Tg has poor accuracy for predicting malignancy in follicular or Hürthle cell neoplasms on fine needle aspiration.
Fig. 1.
Box plot comparison of serum thyroglobulin values between benign and malignant neoplasms with follicular or Hürthle cell neoplasm on fine needle aspiration.
Table 1.
Clinical characteristics of study subjects
  Total FNA cytology P-value
Follicular neoplasm Hurthle cell neoplasm
Number of subjects (%) 111 98 (88.2%) 13 (11.8%)  
Age (year) 46.8 ± 11.9 46.2 ± 12.0 50.9 ± 10.7 0.162
Sex ratio, female/male 90/21 79/19 11/2  
TSH (mIU/L) 1.75 ± 1.52 1.59 ± 1.17 2.96 ± 2.86 0.112
Tg (μg/L) 166.2 ± 467.0 173.8 ± 494.1 110.4 ± 166.9 0.458
Nodule size (mm) 18.9 ± 15.7 19.5 ± 16.1 14.5 ± 12.4 0.277

Data were mean±SD, TSH, thyroid stimulating hormone; Tg, thyroglobulin.

Table 2.
Histologic diagnosis of study samples
  FNA diagnosis
Follicular neoplasm
n (%)
Hürthle cell neoplasm
n (%)
Malignant 35 (100) 6 (100)
Papillary carcinoma 15 (42.9) 3 (50.0)
Follicular carcinoma 12 (34.3) 2 (33.3)
Medullary carcinoma 2 (5.7) 1 (16.7)
FV PC 2 (5.7) 0
PC with FC 4 (11.4) 0
Benign 63 (100) 7 (100)
Nodular hyperplasia(benign) 32 (50.8) 5 (71.4)
Follicular adenoma 27 (42.9) 1 (14.3)
Hürthle cell adenoma 1 (1.6) 1 (14.3)
Hashimoto's thyroiditis 2 (3.2) 0

FNA, fine needle aspiration; PC, papillary carcinoma; FC, follicular carcinoma; FV PC, follicular variant papillary carcinoma.

Table 3.
Comparison of malignant and benign histology groups
  Benign Malignant P-value
Number of subjects 70 41  
Age (year) 47.0 ± 12.6 46.4 ± 10.9 0.797
TSH (mIU/L) 1.80 ± 1.67 1.67 ± 1.20 0.659
Tg (μg/L) 202.8 ± 571.1 101.3 ± 153.9 0.280
Nodule size (mm) 20.2 ± 14.1 16.7 ± 18.1 0.262
FNA results      
Follicular neoplasm, n (%) 63 (64.3) 35 (35.7) 0.545
Hürthle cell adenoma, n (%) 7 (53.8) 6 (46.2) 0.545
Table 4.
Clinicopathologic parameters associated with malignant pathology in patients with follicular and Hürthle cell neoplasm on cytology
  Relative risk 95% CI P-value
Male gender 1.070 0.398-2.876 0.893
Tumor size (≥ 4 cm) 0.834 0.241-2.887 0.774
Age ≥60 1.479 0.476-4.590 0.499
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        Diagnostic Value of Preoperative Serum Thyroglobulin Measurement for the Diagnosis of Malignancy in Follicular or Hürthle Cell Neoplasms of the Thyroid Gland
        Kosin Med J. 2014;29(1):17-22.   Published online December 17, 2014
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