الفهرس 
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Abstract
Introduction: The incidence of differentiated thyroid cancers has been increased worldwide and is considered to be the most common endocrine malignancy. Prognosis of thyroid cancer ranges from excellent, long-term survival in young patients with papillary thyroid carcinoma, to dismal in those patients with anaplastic tumors. Assessing prognosis and selecting appropriate treatment for patients with newly diagnosed thyroid carcinoma can therefore be a complex process. The diagnosis of local recurrence and distant metastasis remains to pose a diagnostic challenge in clinical practice. Measurement of tumor markers, when used along with other diagnostic tests can be useful in the diagnosis as well as follow up of thyroid tumors. However, the results have often been disappointing. Aim of the work: Therefore the present study was designed to assess the value of tumor markers in the diagnosis as well as detection of recurrence or distant metastasis of thyroid tumors after therapy. - Subjects and Methods: The present study was conducted on 25 patients attending General Surgery Department, Mansoura University Hospital suffering from thyroid swelling wither benign or malignant. In addition, ten healthy subjects are studied as a reference group. All patients were subjected to CBC, liver function tests, renal function tests, thyroid profile (FT3, FT4, TSH) and tumor markers assay (Tg and CEA) Results: There was a non-significant difference between the studied groups as regards routine laboratory data except fasting blood glucose, which was high in benign group compared to both malignant group and controls. Preoperative TSH level was higher in the malignant group and returned its normal level at three months interval postoperative. Both pre and postoperative FT3 and FT4 were non-significantly different between the three studied groups. Preoperative serum thyroglobulin was significantly higher in both benign and malignant groups compared to controls. Serum thyroglobulin was higher during follow up at one week and three months postoperative. Both preoperative and postoperative values of serum CEA were non-significantly different from that of the controls. A significant positive correlation was demonstrated between thyroglobulin and TSH while non-significant correlation was noticed between Tg and FT3 and FT4. Conclusion: Serum thyroglobulin can be used as an adjuvant test in detection of recurrent disease or distant metastasis. Serum CEA level is of no value in diagnosis or detection of recurrence or distant metastasis of thyroid cancer. Recommendations: Serum Tg assay should be coupled with the measurement of anti-thyroglobulin antibody concentration in the same sample. Stimulated thyroglobulin (either by TSH or by T4 withdrawal) level should be studied in patients with normal postoperative Tg. Patients with elevated postoperative Tg level must be carefully investigated for tumor recurrence or distant metastasis. Thyroglobulin assay must be performed regularly during the monitoring of differentiated thyroid neoplasms