Preoperative thyroid stimulating hormone level as risk factor for differentiated thyroid cancer

Authors

  • Asem Fayed Moustafa Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
  • Mohammed Sabery Ammar Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
  • Asmaa El-Hantour Department of General Surgery, Damanhour Teaching Hospital, Behera, Egypt
  • Ahmed Farag El-Kased Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

DOI:

https://doi.org/10.18203/2349-2902.isj20191252

Keywords:

Thyroid stimulating hormone, Fine needle aspiration cytology

Abstract

Background: The objective of the study was to explore the relationship between TSH and differentiated thyroid cancer.

Methods: From September 2017-September 2018, two groups included 247 euthyroid patients with thyroid swelling who had thyroidectomy studied retrospectively and prospectively by observing preoperative TSH level. Euthyroid adult patients with differentiated thyroid cancer and benign thyroid conditions and euthyroid patients with any thyroid diseases who will going to have thyroidectomy were included otherwise other thyroid conditions were excluded. Patients were classified into 192 retrospective cases (Group I) and 55 prospective cases (Group II).

Results: Increased age of malignant cases with a female predominance. All cases presented with a neck swelling. Clinically in group I nodular swelling in 156 cases (81.2%), diffuse swelling in 36 cases (18.8%) and in group II, nodular swelling in 47 cases (85.5%) and diffuse swelling in 8 cases (14.5%). Histopathology of group I thyroid adenoma in 5 cases (4.8%) and multinodular goiter in 100 cases (95.2%). In addition 80 cases (92%) were papillary carcinoma and follicular carcinoma in 7 cases (8%) while in group II; multinodular goiter in29 cases (100%) and papillary carcinoma in 21 cases (80.8%) as well as follicular carcinoma in 5 cases (19.2%) in malignant cases. Group I showed a significant increase in TSH in malignant cases with the same finding in group II.

Conclusions: TSH is an indicator for thyroid malignancy and FNAC biopsy is recommended for thyroid swellings showed elevated TSH.

 

References

Kitahara CM, Sosa JA. The changing incidence of thyroid cancer. Nat Rev Endocrinol. 2016;12:646-53.

Durante C, Costante G, Lucisano G, Bruno R, Meringolo D, Paciaroni A, et al. The natural history of benign thyroid nodules. JAMA. 2015;313:926-35.

Brito JP, Hay ID, Morris JC. Low risk papillary thyroid cancer. Br Med J. 2014;348:30-45.

Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. Lancet. 2016;338(10061):2783-95.

He LZ, Zeng TS, Pu L, Pan SX, Xia WF, Chen LL. Thyroid hormones, autoantibodies, ultrasonography and clinical parameters for predicting thyroid cancer. Int J Endocrinol. 2016;2016:8215834.

Perros P, Boelaert K, Colley S, Evans C, Evans RM, Gerrard Ba G, et al. Guidelines for the management of thyroid cancer. Clin Endocrinol. 2014;81:1-122.

Pitoia F, Miyauchi A. American Thyroid Association Guidelines for thyroid nodules and differentiated thyroid cancer and their implementation in various care settings. Thyroid. 2015;26:319-21.

Santosh UP, Kumar KBS, Trupthi MC, Boobalan S. A comprehensive approach to thyroid swelling: Clinical, sonographic, cytological and histopathological correlation. Otorhinolaryngol Clin Int J. 2014;2:28-31.

Borsaikia K, Patar M. Clinico-pathological Study of Thyroid Swellings with Some Emphasis on Geographical and Community Distribution:A Hospital Based Analysis. Bengal J Otorhinolaryngol Head Neck Surg. 2016;24(2):73-9.

Halbhavi SN, Ganjigatti M, Kuntoji SB, Karikazi MA. Clinicopathological study of thyroid swellings in HSK hospital in Karnataka, India. Int Surg J. 2018;5(2):420-5.

Tamhane S, Gharib H. Thyroid nodule update on diagnosis and Management. Clin Diabet Endocrino. 2016;2:17-26.

Hirachand S, Maharjan M, Lakhey M, Thapa R, Kafle S. Accuracy of fine needle aspiration cytology in diagnosis of thyroid swelling. J Pathol Nepal. 2013;3:433-6.

Haymart MR, Repplinger DJ, Leverson GE. Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocrinol Metab. 2008;93(3):809-14.

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(11):295-01.

Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedüs L, AACE/ACE/AME Task Force on Thyroid Nodule. Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules:2016 Update appendex. Endocrin Pract. 2016;22(1):1-60

Gerschpacher M, Gobl C, Anderwald C, Gessl A, Krebs M. Thyrotropin serum concentrations in patients with papillary thyroid microcancers. Thyroid. 2010;20:389-92.

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Published

2019-03-26

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Original Research Articles