Clin Exp Otorhinolaryngol.  2014 Dec;7(4):312-318. 10.3342/ceo.2014.7.4.145.

Preoperative Subclinical Hyperthyroidism in Patients With Papillary Thyroid Carcinoma

• Ahn D
• Sohn JH
• Jeon JH
• Park J

• KMID: 2278373
• DOI: http://doi.org/10.3342/ceo.2014.7.4.145

Abstract

OBJECTIVES
Numerous studies have reported the effects of subclinical hyperthyroidism on the cardiovascular system, osteoporosis, and metabolic syndrome. However, there are few studies examining the relationships between subclinical hyperthyroidism and thyroid cancer. The aim of this study was to investigate the relationships between preoperative subclinical hyperthyroidism and clinicopathological characteristics in patients with papillary thyroid carcinoma (PTC) in terms of thyroid-stimulating hormone (TSH) levels and TSH receptor antibody (TRAb) values.
METHODS
Between January 2001 and December 2007, 462 patients were eligible for analysis in our study; we compared the clinicopathological characteristics of 39 preoperative subclinical hyperthyroidism patients with those of 423 euthyroid patients.
RESULTS
There were no statistical differences between the 2 groups with respect to age, male to female ratio, primary tumor size, extrathyroidal extension (ETE), multifocality, lymph node metastasis, TNM and AMES stages, recurrence, and survival, despite significant difference in TSH concentrations between the 2 groups. In the evaluation for TRAb, primary tumor size was significantly larger in patients with normal TRAb than in patients with elevated TRAb. When the patients were subdivided into 4 categories according to TRAb values (<5.0%; 5.0%-10.0%; 10.1%-15.0%; >15.0%), tumor size and ETE were significantly different. However, we could not find linear relationships in the increase or decrease of TRAb values.
CONCLUSION
The results of our study suggest that subclinical hyperthyroidism is not independently associated with tumor aggressiveness and prognosis in PTC in spite of reduced TSH levels and increased TRAb values as compared with euthyroid patients.

Keyword

Papillary carcinoma; Thyroid; Hyperthyroidism; Thyrotropin

MeSH Terms

Carcinoma, Papillary
Cardiovascular System
Female
Humans
Hyperthyroidism*
Lymph Nodes
Male
Neoplasm Metastasis
Osteoporosis
Prognosis
Receptors, Thyrotropin
Recurrence
Thyroid Gland
Thyroid Neoplasms*
Thyrotropin
Receptors, Thyrotropin
Thyrotropin

Figure

• 

  Fig. 1 Mean age (A) and tumor size (B) according to preoperative thyroid-stimulating hormone (TSH) receptor antibody values. r=Pearson correlation coefficient.

• 

  Fig. 2 Incidence of extrathyroidal extension (A), multifocality (B), lymph node metastasis (C), and recurrence (D) according to preoperative thyroid-stimulating hormone (TSH) receptor antibody values. Ptrend =P-value for trend.

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