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

Sung Yup Joung; Hoon Yub Kim; Woo Sang Ryu; Sang Uk Woo; Gil Soo Son; Jae Bok Lee; Jeoung Won Bae

doi:10.16956/kjes.2010.10.4.220

Journal List > Korean J Endocr Surg > v.10(4) > 1060007

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Joung, Kim, Ryu, Woo, Son, Lee, and Bae: Preoperative Thyroid-stimulating Hormone Levels as a Predictor of Thyroid Carcinoma

Review Article

Korean J Endocrine Surg 2010;10(4):220-223.

Published online: 18 December 2010

DOI: https://doi.org/10.16956/kjes.2010.10.4.220

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

Sung Yup Joung, Hoon Yub Kim, Woo Sang Ryu, Sang Uk Woo, Gil Soo Son, Jae Bok Lee, Jeoung Won Bae

Department of Surgery, Korea University College of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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. (Korean J Endocrine Surg 2010;10:220-223)

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Keywords: Thyroid carcinoma, Thyroid stimulating hormone, Differentiated thyroid cancer

REFERENCES

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Table 1.

Clinical characteristics between malignant and benign lesions

	Malignancy	No malignancy	P value
Case	235	109
Sex (M/F)	34/201	16/93	0.9588
Mean age (range)	49.95 (13∼79)	49.65 (20∼77)	0.8320
Mean nodule size	1.19	2.12	＜0.0001
(range)	(0.1∼7 cm)	(0.3∼6.5 cm)
No. of nodule			0.0109
Single	161 (68.51%)	89 (81.65%)
Multiple	74 (31.49%)	20 (18.35%)

Table 2.

Clinical characteristics of papillary and follicular carci noma

Number		224	11
Gender	Male	34 (18%)	0 (0%)
	Female	190 (82%)	11 (100%)
Age (Mean)		13∼79 (50)	32∼79 (51.2
Mean size (cm)		1.5	3.4
No. of nodules	Single	151 (67%)	10 (91%)
	Multiple	73 (33%)	1 (9%)
Lymph node metastasis	Negative	154 (69%)	11 (100%)
	Positive	70 (31%)	0 (0%)

Table 3.

Mean preoperative TSH levels compare with malignan and benign thyroid lesions

	Malignacy	No malignac	cy P valu
Total case	235	109
Mean TSH (ml/L)	2.09	1.49	0.0056
(Range)	(0.02∼24.89)	(0.02∼6.36	)
Exclusion of levothyroxine	224	108	0.0012
Mean TSH (ml/L)	2.15	1.45
(Range)	(0.02∼24.89)	(0.02∼5.38	)

Table 4.

Analysis of clinical findings accordings to the TSH levels

TSH (uIU/ml)	No.	Age	Size (cm)	Sex		No. of nodules
TSH (uIU/ml)	No.	Age	Size (cm)	M	F	Single	Multiple
＜0.17	29
No malignancy	10	52.4	1.9	1	9	9	1
Malignancy	19	46.8	1.2	2	17	13	6
0.17∼4.05	291
No malignancy	93	48.5	2.2	14	79	74	19
Malignancy	198	50.8	1.7	29	169	135	63
＞4.05	26
No malignancy	6	51.5	2.3	1	5	6	–
Malignancy	20	44.8	1.0	3	17	15	5

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.

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