J Korean Surg Soc.  2013 Jul;85(1):15-19.

Clinical implications of preoperative thyrotropin serum concentrations in patients who underwent thyroidectomy for nonfunctioning nodule(s)

• Kim D
• Park JW

Abstract

PURPOSE
Thyroid stimulating hormone (TSH) measurement is the most sensitive screening test for thyroid dysfunction. TSH is a well-known thyroid growth factor but its pathogenic role in thyroid oncogenesis remains to be clarified. The purpose of the present study was to evaluate the relationship between clinicopathologic characteristics of nonfunctioning thyroid nodules and preoperative TSH serum concentrations.
METHODS
Serum TSH concentrations can be affected by many factors. After exclusion of these confounding factors, a total of 126 patients who underwent thyroidectomy from Januray 2009 to December 2010 were included in this study. Average age was 45.4 +/- 10.6 years and male:female ratio was 1:2.9. There were 11 patients with benign nodules, 34 patients with papillary thyroid microcarcinoma (PTMC) of less than 5 mm in maximal diameter, 66 patients with PTMCs of more than 5 mm but not more than 10 mm in maximal diameter, and 15 patients with papillary thyroid carcinoma (PTC) of more than 10 mm in maximal diameter.
RESULTS
TNM stages of PTCs correlated with higher preoperative TSH serum concentrations. There were trends of higher preoperative TSH serum concentrations in patients who had extrathyroidal extension (P = 0.059) and advanced N stages (P = 0.120) but did not reach statistical significance. Patients' age, sex, and tumor volume did not seem to affect preoperative TSH serum concentrations significantly.
CONCLUSION
In patients who have PTCs without clinical, immunological, or ultrasonographic evidence of thyroiditis, higher preoperative TSH serum concentrations within the normal range might suggest advanced TNM stages.

Keyword

Thyroid stimulating hormone; Thyroid nodule; Papillary thyroid carcinoma; TNM stage

MeSH Terms

Carcinoma
Carcinoma, Papillary
Cell Transformation, Neoplastic
Factor IX
Humans
Mass Screening
Reference Values
Thyroid Gland
Thyroid Neoplasms
Thyroid Nodule
Thyroidectomy
Thyroiditis
Thyrotropin
Tumor Burden
Carcinoma
Carcinoma, Papillary
Factor IX
Thyroid Neoplasms
Thyrotropin

Figure

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  Fig. 1 Thyroid stimulating hormone (TSH) serum concentrations according to T stages.

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  Fig. 2 Thyroid stimulating hormone (TSH) serum concentrations according to the presence of extrathryoidal extension. ETE, extrathryoidal extension.

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  Fig. 3 Thyroid stimulating hormone (TSH) serum concentrations according to N Stages.

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  Fig. 4 Thyroid stimulating hormone (TSH) serum concentrations according to benignity and TNM stages.

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