Association of preoperative serum thyroid-stimulating hormone levels with thyroid cancer in patients with nodular thyroid disease

Khan, Muhammad Aqeel; Malik, Nidhi; Khan, Kamran Hakeem; Shahzad, Muhammad Faheem

doi:10.4103/1450-1147.207277

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…In our study, we have determined the mean pre-operative TSH levels of all thyroid carcinoma patients enrolled and it was found to be 2.04 ± 1.79. Our mean TSH level is comparable with a previous study done in Pakistan where they found a mean TSH of 1.94 15. Similarly a study conducted in India showed, that majority of thyroid carcinoma patients (88.3%) had their TSH levels between 1.71 – 5.5 mIU/l and among south Korean population, it was found to be 1.95 ± 0.9 mIU/l 3,16.…”

Section: Discussionsupporting

confidence: 88%

Pre-operative serum TSH levels: A risk factor for advanced metastatic differentiated thyroid carcinoma

et al. 2019

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Background and Objective: As the thyroid cancer incidence is increasing, the search for its risk factor is becoming more important. Serum thyroid stimulating hormone (TSH) levels being a growth factor for normal thyroid tissue, is also considered as growth promotor of cancer cells. In our study we aimed for pre-operative serum TSH levels of Differentiated thyroid cancers (DTC) done before their first surgery and determined its association with advanced disease in terms of stage, multifocal disease, lymph node involvement and distant metastasis. Methods: We have conducted a retrospective review of thyroid cancers from 1st January 2008 to 31st December 2017. Out of 281, 142 cases were included according to inclusion criteria. We noted the demographic details of participants, their histopathological diagnosis and serum TSH levels done before first surgery from the medical records. We calculated the stage of tumor through modified American Joint Committee (AJCC) staging system. Results: Out of 147 participants, 89.4% had papillary carcinoma or its variants whereas 10.6% reported follicular carcinoma. The mean pre-op TSH level of the patients included was 2.04 ± 1.79. In addition to the descriptive analysis, the univariate regression analysis revealed that the association of serum TSH levels was found to be statistically insignificant with advanced stage of thyroid cancer, multifocal disease, lymph node metastasis and distant metastasis respectively. Conclusion: The serum TSH levels before surgery was not associated with poor prognosis of differentiated thyroid cancer with respect to higher staging, multifocal disease, lymphatic or distant metastasis. doi: https://doi.org/10.12669/pjms.35.5.704 How to cite this:Batool S, Afridi MS, Khoja A, Islam N. Pre-operative serum TSH levels: A risk factor for advanced metastatic differentiated thyroid carcinoma. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.704 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 88%

Pre-operative serum TSH levels: A risk factor for advanced metastatic differentiated thyroid carcinoma

et al. 2019

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“…The overall prevalence of cancer among patients with thyroid nodules was 13.8%, which is higher than that in neighboring countries, which is reported to be approximately 9-10% [8][9][10]. TSH level was significantly associated with thyroid cancer (P -value 0.01), which is consistent with studies that showed an increased risk of thyroid cancer with an increase in TSH level [12,18].…”

Section: Discussionsupporting

confidence: 85%

“…Other studies from the Middle East showed thyroid cancer in 10.5% of patients with thyroid nodules in Jordan [8] and rates of 5% in Saudi Arabia in one study [9] and 10.4% in another [10]. In the United Arab Emirates, the prevalence was 9% among those of Emirati origin [11] and 5% among those with thyroid nodules in Pakistan [12]. Papillary thyroid cancer is the most common type of thyroid cancer, accounting for 80-95% of all thyroid cancers, with an incidence rate that has continued to increase globally in recent decades [13].…”

Section: Introductionmentioning

confidence: 77%

Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic

et al. 2020

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Background: The prevalence of thyroid cancer is increasing worldwide. No previous data are available on the prevalence of thyroid cancer in Yemen. We performed this study to determine the prevalence of thyroid cancer among patients with thyroid nodules in Yemen. Methods: A retrospective chart review was performed for 550 patients with thyroid nodules who underwent fine needle aspiration and/or thyroid surgery at a private endocrine clinic and at an endocrine clinic in a tertiary hospital in Yemen over a 3-year period from October 2016-2019. The prevalence of thyroid cancer; the sonographic findings, Bethesda classification, age, sex, thyroid stimulating hormone (TSH) levels of the patients; and the nodule size and number were reviewed. Results: A total of 550 charts were reviewed [501 females (91.1%) and 49 males (8.9%)]. The thyroid cancer prevalence among the patients was 13.8% (CI = 10.9-16.7), and the mean age of the patients was 38.5 years (SD = 12.2). The TSH level and the rate of cancer were significantly related (P = 0.01), but no significant difference in the prevalence of thyroid cancer was found between females (13.4%) and males (18.4%) (P = 0.334). When correlating the rate of cancer with the ultrasound guided fine needle aspiration (UG-FNA) result, those with Bethesda system category III and IV, V and VI had malignancy rates of 20.8, 27.2, 52.4 and 69.2%, respectively. Thyroid nodules highly suspicious for malignancy on ultrasound had a 70% cancer diagnosis rate. The most common thyroid cancer was papillary cancer (71%), followed by follicular cancer (23.7%). Among those undergoing surgery, 44.2% had thyroid cancer, and 5.2% had a premalignant diagnosis. Conclusion: Thyroid cancer has a higher prevalence in Yemen than in other middle eastern countries. Our study also reports a higher rate of follicular thyroid cancer than that in other published data, which has to be confirmed by further studies. The malignancy and premalignant diagnosis rate was~50% in our patients who underwent surgery. Many centers in Yemen still do not perform FNA before thyroid surgery. It is important that other centers in the country start emphasizing the need for FNA before surgery. This will decrease the number of unnecessary surgeries and associated complications.

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“…Some reports had shown that patients with elevated thyroid-stimulating hormone (TSH) have higher incidence of thyroid malignancy 14 . In our study, we found that TSH was significantly associated with PTMC in univariate analysis, but it was not independent risk factor in multivariate analyses.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of ultrasound features and sex of fetuses in female patients with papillary thyroid microcarcinoma

Hou

Wei

Tang

et al. 2018

Sci Rep

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Little work has been done on the prediction of papillary thyroid microcarcinoma in female patients who have given birth to children, which may be different from other people. We performed a retrospective review of female patients who underwent thyroidectomy, aiming at identifying special predictors of papillary thyroid microcarcinoma in female patients who have given birth to children. Univariate analysis was used to identify potential covariates for the prediction of papillary thyroid microcarcinoma. Multivariable logistic regression analysis was used to identify independent predictors and construct a regression model based on a training cohort (246 patients) and then the regression model was validated using an independent cohort (80 patients). We found that having not more than one boy, taller-than-wide shape, poorly defined margin, marked hypoechogenicity, and microcalcification were independent risk factors for the papillary thyroid microcarcinoma in multivariate analyses. The combined predictive formula had a high predictive effect for papillary thyroid microcarcinoma (AUC = 0.938 for training cohort and 0.929 for validation cohort, respectively). The combined predictive formula has clinical value in the prognosis of papillary thyroid microcarcinoma and it may be simple and effective to ask fertility condition of patients to increase the US diagnosis accuracy of papillary thyroid microcarcinoma.

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Association of preoperative serum thyroid-stimulating hormone levels with thyroid cancer in patients with nodular thyroid disease

Cited by 9 publications

References 15 publications

Pre-operative serum TSH levels: A risk factor for advanced metastatic differentiated thyroid carcinoma

Pre-operative serum TSH levels: A risk factor for advanced metastatic differentiated thyroid carcinoma

Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic

Diagnostic value of ultrasound features and sex of fetuses in female patients with papillary thyroid microcarcinoma

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