Higher serum TSH in thyroid cancer patients occurs independent of age and correlates with extrathyroidal extension.
ABSTRACT It has previously been shown that higher serum TSH is associated with increased thyroid cancer incidence and advanced-stage disease. In the healthy adult population, mean TSH increases with age. As age over 45 years is a known prognostic indicator for thyroid cancer, it is important to know whether higher TSH in patients with thyroid cancer occurs independent of age.
To determine the relationship between higher TSH, cancer and age.
A retrospective cohort study.
A total of 1361 patients underwent thyroid surgery between May 1994 and December 2007 at a single institution. Of these patients, 954 had pathological data, preoperative TSH and complete surgical history available. Data were analysed in relation to age and TSH.
Mean TSH was significantly higher in cancer patients regardless of age < 45 years or >or= 45 years (P = 0.046 and P = 0.027, respectively). When examining age groups < 20, 20-44, 45-59 and >or= 60 years, there was a trend of rising mean TSH with age. Despite the rise in the benign subgroups, mean TSH was consistently higher in those with cancer vs. those without. On multivariate analysis, higher TSH was independently associated with cancer (P = 0.039) and pathological features of Hashimoto's thyroiditis (P = 0.001) but not with age (P = 0.557). On multivariate analysis of high-risk features associated with poor prognosis, there was a significant association between higher TSH and extrathyroidal extension (P = 0.002), whereas there was no clear relationship with age, tumour size > 4 cm, and distant metastases.
Independent of age, thyroid cancer incidence correlates with higher TSH. Higher TSH is associated with extrathyroidal extension of disease.
- SourceAvailable from: Dilek Gogas Yavuz
Article: Vakalarla subklinik hipotiroidi11/2014;
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ABSTRACT: Abstract Objective: This prospective study investigates the relationship between Hashimoto's Thyroiditis (HT) and thyroid cancer (TC) in patients with thyroid nodules (TNs). Methods: We prospectively examined 2100 patients with 2753 TNs between January 5, 2010 and August 15, 2013. A total of 2023 patients with 2669 TNs met the inclusion criteria of TN >5 mm and age >18 years (y). Each patient had blood drawn prior to fine-needle aspiration biopsy (FNAB) for the following measurements: TSH, free T4, free T3, thyroid peroxidase antibody (TPO Ab), and antithyroglobulin antibody (TgAb). Diagnosis of TC was based on pathology analysis of thyroidectomy tissue. Associations of TC with the independent variables were determined by univariate and multivariate logistic regression analysis and reported as adjusted odds ratio (OR) with 95% confidence interval (CI). Results: 248 malignant nodules were found in 233 patients. There was an association of TC with both increased serum TgAb concentration and age <45y. An elevated serum TgAb concentration was found in 10.2% of patients (182 of 1790) with benign nodules as compared to 20.6% of patients (48 of 233) with malignant nodules (p=<0.0001). TgAb (OR=2.24: CI=1.57, 3.19) and TSH >1 uIU/ml (OR (95% CI)) OR: 1.49 (1.09, 2.03) were significant predictors of TC in multivariate analysis controlling for age and gender. TC was not associated with serum concentrations of TPO Ab. Conclusion: In patients with TN, elevated serum concentration of TgAb and TSH >1 uIU/ml are independent predictors for TC. The association between HT and TC is antibody specific.Endocrine Related Cancer 09/2014; · 5.26 Impact Factor
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ABSTRACT: Thyrotropin (TSH) is the major regulator and growth factor of the thyroid. TSH may be important in the development of human thyroid cancer, with both suggestive animal models and clinical evidence, although definitive proof is still required. Applications for TSH in thyroid cancer management include TSH stimulation of radioiodine uptake, enhancement of biochemical monitoring through thyroglobulin measurement, and long-term suppression of TSH with supraphysiologic levothyroxine. This review synthesizes current knowledge of TSH in both the development and management of differentiated thyroid cancer.Endocrinology and metabolism clinics of North America. 06/2014; 43(2):367-383.