The early changed rate of sTg to TSH ratio had superior predictive value in evaluating long-term prognosis for pulmonary metastatistic differentiated thyroid carcinoma

OBJECTIVE: This study aims to explore the predictive value of serological markers for the prognosis of pulmonary metastatic differentiated thyroid carcinoma (pmDTC). MATERIALS AND METHODS: This retrospective study enrolled 149 pmDTC patients who underwent thyroidectomy and radioactive iodine therapy (RAI). The patients were divided into disease control (DC) group and progressive disease (PD) group at the final follow-up. Univariate and multivariate logistic regression, receiver operating characteristic curves, and Kaplan‒Meier analysis were used to analyze the prognostic factors. RESULTS: = 0.031) were independent predictors of PD. ΔsTg/TSH demonstrated the highest predictive value for PD, with a sensitivity, specificity, negative predictive value, and accuracy of 100.0%, 88.4%, 100.0%, and 91.3%, respectively. CONCLUSION: ΔsTg/TSH demonstrates superior predictive value for PD in pmDTC, suggesting that serial monitoring of sTg and TSH enables earlier and more precise identification of pmDTC patients who would not derive clinical benefit from RAI.