Korean J Endocr Surg.  2010 Dec;10(4):220-223. 10.16956/kjes.2010.10.4.220.

Preoperative Thyroid-stimulating Hormone Levels as a Predictor of Thyroid Carcinoma

• Joung SY
• Kim HY
• Ryu WS
• Woo SU
• Son GS
• Lee JB
• Bae JW

• KMID: 2375472
• DOI: http://doi.org/10.16956/kjes.2010.10.4.220

Abstract

PURPOSE
This study investigated the effects of serum thyroid-stimulating hormone (TSH) levels in predicting malignancy-associated differentiated thyroid cancer (DTC) and benign thyroid nodules.
METHODS
Between January 2005 and December 2007, 346 patients underwent thyroid surgery at one hospital. Their records were retrospectively reviewed.
RESULTS
Sixty-nine percent (237 of 346) of the patients had DTC. The mean preoperative TSH level was higher than in the malignant group (5 uIU/ml vs 0.4 uIU/ml). The rate of malignancy was the 71% in patients with TSH levels >5 uIU/ml. The TSH level of DTC with metastasis of the lymph node was higher than that with non-metastasis (3.08 uIU/ml vs 2.09 uIU/ml, P<0.01)
CONCLUSION
The likelihood of DTC increases with higher serum TSH concentration. Serum TSH level might be useful in predicting malignant nodular thyroid lesion.

Keyword

Thyroid carcinoma; Thyroid stimulating hormone; Differentiated thyroid cancer

MeSH Terms

Humans
Lymph Nodes
Neoplasm Metastasis
Retrospective Studies
Thyroid Gland*
Thyroid Neoplasms*
Thyroid Nodule
Thyrotropin*
Thyrotropin

Figure

• 

  Fig. 1 Distribution of serum TSH level comparison with age in differentiated tyroid cancer. The serum TSH level was highly elevated in high risk group for 20∼49 years old.

Reference

1.The Korean Society of Pathologists. Textbook of Pathology. Endocrine Disease. 7th ed.Gomoonsa;2010.

2.Pearce EN., Braverman LE. Papillary thyroid microcarcinoma outcomes and implications for treatment. J Clin Endocrinol Metab. 2004. 89:3710–2.

3.Udelsman R., Chen H. The current management of thyroid cancer. Adv Surg. 1999. 33:1–27.

4.Stocker DJ., Burch HB. Thyroid cancer yield in patients with Graves' disease. Minerva Endocrinol. 2003. 28:205–12.

5.Shi Y., Zou M., Farid NR. Expression of thyrotrophin receptor gene in thyroid carcinoma is associated with a good prognosis. Clin Endocrinol (Oxf). 1993. 39:269–74.

6.Jung HJ., Hong SJ. Central neck lymph node metastasis from papillary thyroid cancer. J Korean Surg Soc. 1998. 55:787–93.

7.Xing M. BRAF mutation in papillary thyroid cancer: pathogenic role, molecular bases, and clinical implications. Endocr Rev. 2007. 28:742–62.

8.Papini E., Guglielmi R., Bianchini A., Crescenzi A., Taccogna S., Nardi F, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002. 87:1941–6.

9.Cappelli C., Pirola I., Cumetti D. Is the anteroposterior and transverse diameter ratio of nonpalpable thyroid nodules a sonographic criteria for recommending fine-needle aspiration cytology? Clin Endocrinol. 2005. 63:689–93.

10.Boelaert K., Horacek J., Holder RL., Watkinson JC., Sheppard MC., Franklyn JA. Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J Clin Endocrinol Metab. 2006. 91:4295–301.

11.Jin J., Machekano R., Mchenry CR. The utility of preoperative serum thyroid-stimulating hormone level for predicting malignant nodular thyroid disease. Am J Surg. 2010. 199:294–8.

12.Pujol P., Daures JP., Nsakala N., Baldet L., Bringer J., Jaffiol C. Degree of thyrotropin suppression as a prognostic determinant in differentiated thyroid cancer. J Clin Endocrinol Metab. 1996. 81:4318–23.

13.Haymart MR. Understanding the relationship between age and thyroid cancer. Oncologist. 2009. 14:216–21.