The Difference in Thyroid Stimulating Hormone Levels between Differentiated Carcinoma and Benign Enlargement

Abstract

Introduction Papillary and follicular thyroid carcinoma are common head and neck cancers. This cancer expresses a thyroid stimulating hormone (TSH) receptor that plays a role as a cancer stimulant substance. This hormone has a diagnostic value in the management of thyroid carcinoma. Objective The present study aimed to determine the difference in TSH levels between differentiated thyroid carcinoma and benign thyroid enlargement. Methods The present research design was a case-control study. The subjects were patients with thyroid enlargement who underwent thyroidectomies at the Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Thyroid stimulating hormone levels were measured before the thyroidectomies. The inclusion criteria for the case group were: 1) differentiated thyroid carcinoma, and 2) complete data; while the inclusion criteria for the control group were: 1) benign thyroid enlargement, and 2) complete data. The exclusion criteria for both groups were: 1) patients suffering from thyroid hormone disorders requiring therapy before thyroidectomy surgery, 2) patients receiving thyroid suppression therapy before the thyroidectomy was performed, and 3) patients suffering from severe chronic diseases such as renal insufficiency, and severe liver disease. Results There were 40 post-thyroidectomy case group patients and 40 post-thyroidectomy control group patients. There were statistically significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement ( p = 0.001; odds ratio [OR] = 8.42; 95% confidence interval [CI]: 3.19–36.50). Conclusion Based on these results, it can be concluded that there were significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement.

Prospects of Testing Diurnal Profiles of Expressions of TSH-R and Circadian Clock Genes in Thyrocytes for Identification of Preoperative Biomarkers for Thyroid Carcinoma

“…However, there were no studies designed to evaluate the responses of TSH-R to administering TSH or recombinant human TSH (rhTSH) into tissues containing of benign or malignant thyrocytes. This gap contrasts with the results of intensive research on TSH levels in serum [ 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 89 , 90 , 91 ], circadian clock genes expression [ 2 , 39 , 64 , 70 , 103 , 104 , 105 ] in thyrocytes, and TSH-R gene activation at thyrocytes’ membrane [ 107 , 108 , 109 , 110 , 111 , 112 , 114 , 115 , 116 , 117 , 118 , 119 ] ( Table 1 ).…”

“…Results of intensive testing of TSH concentrations in serum suggested the increase of the risk of malignancy in thyroid nodules in parallel with the increase of these concentrations [ 73 ]. The results of published studies suggested that the likelihood of thyroid cancer increased with increase of serum TSH concentrations [ 74 ], that patients with high serum TSH levels had a significantly higher risk of differentiated carcinoma than patients with low levels [ 75 ], that higher TSH concentrations, even within the normal range, were associated with a subsequent diagnosis of thyroid cancer in individuals with thyroid abnormalities [ 76 ], that the levels of serum TSH in the group with differentiated thyroid cancer was significantly increased compared with that in the benign TN group [ 77 ], and that TSH levels in patients of stage 3 were significantly higher than those in patients in stages 2 and 1 [ 78 ], etc. Therefore, it was concluded that levels of this hormone in serum might have a diagnostic value in the preoperational management of thyroid carcinoma [ 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ].…”

“…Overall, the results suggesting significant association between thyroid cancer and increased TSH levels in serum [ 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ] pointed at an important but not very high diagnostic value of these levels in the preoperative management of thyroid carcinoma [ 89 , 90 , 91 ].…”

The Association Between Type 2 Diabetes Mellitus, Hypothyroidism, and Thyroid Cancer

“…Patients with high TSH levels have a higher risk of differentiated carcinoma than patients with low TSH levels. Thyroid-stimulating hormone levels are an independent predictor for the diagnosis of thyroid malignancies in patients with thyroid gland enlargement ( 27 ). The role of hyperthyroidism in the production of thyroid cancers is unclear.…”

Diagnostic and prognostic value of combined detection of serum Tg, IFN - γ and TgAb in thyroid adenoma

“…The clinical pathogenesis of TA is not completely clear, but relevant studies show that it may be closely related to radiation exposure, genetics, gender, thyroid-stimulating hormone stimulation, etc., with a high incidence in clinical practice, affecting the quality of life of human beings (10). If TA does not receive timely diagnosis and treatment, it may cause malignant transformation of tumor and hyperthyroidism, which increases the difficulty of clinical treatment (11,12). As the best diagnostic method of TA, needle aspiration cytology has high accuracy, but it also has certain trauma.…”