Higher <scp>TSH</scp> level is a risk factor for differentiated thyroid cancer

Kim, Hee Kyung; Yoon, Jee Hee; Kim, Soo Jeong; Cho, Jin Seong; Kweon, Sun-Seog; Kang, Ho‐Cheol

doi:10.1111/cen.12027

Cited by 58 publications

(44 citation statements)

References 39 publications

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“…The possibility of a relationship between the TSH level and thyroid cancer development was first identified by Boelaert et al [22] and was supported by other studies [23,24,25]. Recent studies have suggested that serum TSH levels are independent predictors of papillary and follicular thyroid cancer in patients with thyroid nodules [26]. In a study of 1,500 patients evaluated for thyroid nodules, the prevalence of malignancy gradually increased from 2.8%, when TSH levels were <0.4 mIU/l, to up to 29.7%, when TSH levels were >5.5 mIU/l [22].…”

Section: Discussionmentioning

confidence: 87%

“…Only one study included a healthy control group and reported that no differences were found between thyroid cancer and healthy control groups in TSH values [27]. Kim et al [26] compared TSH levels obtained from euthyroid patients with differentiated thyroid cancer to TSH levels from controls in the general population. The mean TSH level of the case group was significantly higher than the mean TSH level of the control group and associated with differentiated thyroid cancer.…”

Section: Discussionmentioning

confidence: 99%

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Co-Existence of Thyroid Nodule and Thyroid Cancer in Children and Adolescents with Hashimoto Thyroiditis: A Single-Center Study

Keskin¹,

Savaş‐Erdeve²,

Aycan³

2016

Horm Res Paediatr

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Background: Currently, there is an inadequate number of studies on nodule and malignancy development in children and adolescents with Hashimoto thyroiditis (HT). Material and Methods: Patients who were diagnosed with HT between 2004 and 2013 were included in the study. The HT diagnosis was made with a heterogeneous appearance on thyroid ultrasonography and the elevation of antithyroid peroxidase and/or anti-thyroglobulin antibodies. Fine-needle aspiration biopsy (FNAB) was performed in cases with a nodule size >1 cm or who had ultrasonography findings indicating malignancy. Results: A total of 39 (13%) thyroid nodules were detected in 300 patients with a diagnosis of HT. Papillary thyroid carcinoma (PTC) was diagnosed in 2 of the 12 cases in whom FNAB was performed. The thyroid nodule was detected at the same time as HT in the 2 cases with malignancy. The PTC diagnosis was made 2 years after the HT diagnosis in the first case and 3 years later in the second case. The largest diameter of the thyroid nodule was 5 mm in both cases. Conclusion: The thyroid nodule rate on an HT background was found to be 13%, and the thyroid malignancy rate was 0.67% in our study.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Co-Existence of Thyroid Nodule and Thyroid Cancer in Children and Adolescents with Hashimoto Thyroiditis: A Single-Center Study

Keskin¹,

Savaş‐Erdeve²,

Aycan³

2016

Horm Res Paediatr

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“…While the promoting effect of TSH on metastatic cancer is well-established, only recently studies have observed an increased risk of thyroid cancer in subjects with serum TSH concentrations in the upper normal range (34). These observations are consistent with evidence that thyroid cancer risk is increased in endemic goiter iodine deficient areas (35).…”

Section: The Thyroid Model In Endocrine Oncogenesismentioning

confidence: 99%

Grand Challenges in Cancer Endocrinology: Endocrine Related Cancers, an Expanding Concept

Belfiore¹,

Perks²

2013

Front. Endocrinol.

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“…A TSH level that is above the normal range or even in the upper range of normal is thought to increase the likelihood that a thyroid nodule is malignant [8–10]. It stands to reason that if the levels of TSH are elevated in patients with thyroid cancer, it is possible that elevated levels of thyroxine (T4) and triiodothyronine (T3) may also be correlated with malignancy as well.…”

Section: Introductionmentioning

confidence: 99%

The T4/T3 quotient as a risk factor for differentiated thyroid cancer: a case control study

Sasson

Kay‐Rivest

Shoukrun

et al. 2017

J of Otolaryngol - Head & Neck Surg

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BackgroundThe incidence of thyroid nodules is increasing among patients in North America. Few of these nodules harbour malignancy, thus further research is required to identify predictive markers of malignant thyroid disease. This study set out to understand the relationship between the levels of fT4 and fT3 and differentiated thyroid cancer.MethodsA case-control study was conducted with 142 cases and 86 controls from the McGill University Teaching Hospitals. All patients underwent thyroid surgery. Cases were defined as patients with malignant nodules confirmed on final pathology and controls were defined as patients with benign nodules. The serological levels of TSH, fT4 and fT3 were measured preoperatively. Odds ratios were determined for each parameter and logistic regressions were calculated between markers and probability of malignancy. Additionally, fT4 values were divided by fT3 values (fT4/fT3 quotient) for each patient and an odds ratio was calculated.ResultsAmongst cases, the mean TSH was 2.25 ± 0.360U/mL, fT4 was 14.8 ± 0.689pmol/L, and fT3 was 4.65 ± 0.463pmol/L. Amongst controls, the mean TSH was 2.36 ± 1.68U/mL, fT4 was 14.3 ± 1.71pmol/L, and fT3 was 5.27 ± 0.957pmol/L. Patients in the control group were more likely to have low TSH, while patients in the case group would have high fT4 and patients in the control group were more likely to have a low fT4. The OR for patients with TSH >4.4U/mL was 2.13 (0.97, 4.65), and for patients with TSH <0.4U/mL was 0.46 (0.22, 0.95). The OR for patients with fT4 > 16pmol/L was 2.10 (1.09, 4.06), and for patients with fT4 < 10pmol/L was 0.45 (0.20, 0.98). The OR for patients with fT3 > 5.5pmol/L was 0.39 (0.14, 1.28). The OR for patients with fT3 < 3pmol/L was 1.83 (0.25, 13.69). The average fT4/fT3 was 3.39 ± 0.206 for cases and 2.93 ± 0.467 for controls. The fT4/fT3 quotient was considered high if it was >3.3 (OR =6.00 (2.94, 12.25)).ConclusionIn this study, a direct relationship between high levels of fT4 and malignancy was uncovered. Furthermore, low levels of TSH and fT4 increased the likelihood that a nodule was benign. In this study a fT4/fT3 ratio >3.3 increased the risk of malignancy by 3.6 times (p-value =0.0013).

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Higher TSH level is a risk factor for differentiated thyroid cancer

Cited by 58 publications

References 39 publications

Co-Existence of Thyroid Nodule and Thyroid Cancer in Children and Adolescents with Hashimoto Thyroiditis: A Single-Center Study

Co-Existence of Thyroid Nodule and Thyroid Cancer in Children and Adolescents with Hashimoto Thyroiditis: A Single-Center Study

Grand Challenges in Cancer Endocrinology: Endocrine Related Cancers, an Expanding Concept

The T4/T3 quotient as a risk factor for differentiated thyroid cancer: a case control study

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