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23085 Thyroglobulin Tumor Marker & Anti-TG

Thyroglobulin Tumor Marker & Anti-TG
Test Code: THYGL
Synonyms/Keywords
TG, Thyroglobulin assay for thyroid cancer, Thyro, Thyrogl Tumor Marker & Anti-TG​
Test Components
Thyroglobulin, Anti-Thyroglobulin​
Useful For
​The primary use of serum Thyroglobulin (Tg) measurements is as a tumor marker for monitoring reoccurrence and progression of patients diagnosed with differentiated thyroid carcinoma (DTC) following surgery and radioiodine therapy.
 
It is not useful for the initial diagnosis and screening for DTC. A variety of hyperactive thyroid states show increased levels of thyroglobulin (goiter, hyperthyroidism, newborns and pregnancy).
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No​ Serum​ Red Top Tube (RTT)​ ​ 2.0 mL​ 0.6 mL​ 0.5 mL​
Collection Processing Instructions
​High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay. It is recommended that patients refrain from consuming any multivitamin or supplement containing biotin for at least 72 hours prior to collection of a blood sample.

Separate serum from cells within 2 hours of collection.
Specimen Stability Information
Specimen Type Temperature Time
Serum​ Refrigerated​ 3 days​
Frozen​ >3 days​
Interference
​High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 1 day​

Chemiluminescent Immunoassay (Siemens, Immulite 2000)​

Test Information
Thyroglobulin when ordered on fluids such as Fine Needle Aspirates must be ordered as a MISC (Miscellaneous) test with the fluid source noted.
 
Patients with thyroid tissue removed (athyrotic) should have very low or undetectable thyroglobulin concentrations after 6 to 8 weeks of surgery. In the absence of thyroid remnants, elevated or rising serum Tg levels are suspicious of recurrent or persistent disease.
 
The American Thyroid Association guidelines for the management of differentiated thyroid cancer (Thyroid 2009; 19: 1167-1214) do not recommend routine preoperative measurement of serum Tg. Athyroid cancer patients (with total thyroidectomy and radioiodine remnant ablation) have serum Tg concentrations <2 ng/mL. Patients with higher levels should be investigated for persistent or recurrent disease. A single rhTSH-stimulated serum Tg <0.5 ng/mL in the absence of anti-Tg antibody has an approximately 98-99.5% likelihood of identifying patients completely free of tumor on follow-up.
 
The presence of anti-Tg antibodies occur in approximately 25% of thyroid cancer patients and 10% of the general population, falsely affecting serum Tg determinations in immunometric assays. All Tg determinations are therefore screened for anti-Tg antibodies, and a comment is appended to the report if the patient is positive for anti-Tg antibodies.
 
Anti-Tg values determined by different methods vary significantly and cannot be compared. Patients should be followed by using same methods. Comparing anti-Tg values from different methods might lead to erroneous clinical interpretations.​

The drug asfotase alfa (STRENSIQ), a recombinant form of alkaline phosphatase, is expected to interfere with in vitro diagnostic assays utilizing an alkaline phosphatase detection system. Test samples from patients taking asfotase alfa with a non-alkaline phosphatase methodology.​ 
Reference Range Information
Performing Location Reference Range
Marshfield​
Thyroglobulin Adult Reference Value:
  Normal thyroid: < or = 43.0 ng/mL
  Athyroid individuals: <3.0 ng/mL
Anti-Thyroglobulin Ab: < or = 40 IU/mL​
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​84432 ​ ​ ​ ​
​86800 ​ ​ ​ ​
Synonyms/Keywords
TG, Thyroglobulin assay for thyroid cancer, Thyro, Thyrogl Tumor Marker & Anti-TG​
Test Components
Thyroglobulin, Anti-Thyroglobulin​
Ordering Applications

Ordering Application Description
​Cerner ​Thyroglobulin Tumor Marker & Anti-TG
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
No​ Serum​ Red Top Tube (RTT)​ ​ 2.0 mL​ 0.6 mL​ 0.5 mL​
Collection Processing
​High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay. It is recommended that patients refrain from consuming any multivitamin or supplement containing biotin for at least 72 hours prior to collection of a blood sample.

Separate serum from cells within 2 hours of collection.
Specimen Stability Information
Specimen Type Temperature Time
Serum​ Refrigerated​ 3 days​
Frozen​ >3 days​
Interference
​High doses of exogenous biotin (also termed Vitamin B7, Vitamin H or Coenzyme R) may interfere with this assay.
Useful For
​The primary use of serum Thyroglobulin (Tg) measurements is as a tumor marker for monitoring reoccurrence and progression of patients diagnosed with differentiated thyroid carcinoma (DTC) following surgery and radioiodine therapy.
 
It is not useful for the initial diagnosis and screening for DTC. A variety of hyperactive thyroid states show increased levels of thyroglobulin (goiter, hyperthyroidism, newborns and pregnancy).
Test Components
Thyroglobulin, Anti-Thyroglobulin​
Reference Range Information
Performing Location Reference Range
Marshfield​
Thyroglobulin Adult Reference Value:
  Normal thyroid: < or = 43.0 ng/mL
  Athyroid individuals: <3.0 ng/mL
Anti-Thyroglobulin Ab: < or = 40 IU/mL​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ Monday through Friday​ 1 day​

Chemiluminescent Immunoassay (Siemens, Immulite 2000)​

For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​84432 ​ ​ ​ ​
​86800 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.