scholarly journals 1744P Serum TSH level: A simple efficient tool to assess risk of thyroid malignancy in euthyroid patients with indeterminate cytology

2021 ◽  
Vol 32 ◽  
pp. S1204
Author(s):  
A. Vinod ◽  
A.V. Pillai ◽  
R.R. Menon
Keyword(s):  
Thyroid Malignancy ◽  
Efficient Tool ◽  
Indeterminate Cytology ◽  
Serum Tsh

scholarly journals Could Serum TSH Levels Predict Malignancy in Euthyroid Patients Affected by Thyroid Nodules with Indeterminate Cytology?

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Carlo Cappelli ◽  
Ilenia Pirola ◽  
Elena Gandossi ◽  
Mario Rotondi ◽  
Davide Lombardi ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Serum Levels ◽  
Histological Diagnosis ◽  
Thyroid Malignancy ◽  
Normal Range ◽  
Additional Tool ◽  
Increased Risk ◽  
Indeterminate Cytology ◽  
Serum Tsh ◽  
Tsh Levels

Background. Serum TSH levels in the upper-normal range were reported to be associated with increased risk of thyroid malignancy. However, measurement of TSH levels is currently not recommended for assessing the risk of malignancy in patients with newly diagnosed thyroid nodules. Objective. To evaluate a possible relationship between the serum levels of TSH and the histological outcome of patients undergoing thyroidectomy for thyroid nodules with indeterminate cytology. Materials and Methods. We collected the clinical data of all patients who had performed ultrasound-guided FNA of thyroid nodules with cytological diagnosis of indeterminate lesions (TIR3A and TIR3B) and serum TSH levels within the normal range. All patients had been submitted to thyroid surgery (hemi or thyroidectomy, as appropriate), and histological diagnosis had been performed. Results. A histological diagnosis of thyroid malignancy was rendered in 74/378 (19.6%) nodules. Patients with histologically proven thyroid malignancy were characterized by higher serum levels of TSH as compared to patients with histologically proven benign nodules (3.03 ± 1.16 vs. 2.37 ± 1.19 mIU/L, p<0.001). To further analyze the role of serum TSH in predicting thyroid cancer, patients were stratified in 4 groups according to quartiles of TSH concentrations. The prevalence of malignancy was 12.2% for the first quartile and 50.0% for the last quartile. ROC curve analysis identified that a serum TSH level of ≥2.7 mIU/L predicted thyroid malignancy with a sensitivity of 61% and a specificity of 65%. Conclusions. TSH levels in the upper-normal range are associated with an increased risk of thyroid malignancy in patients affected by thyroid nodules with indeterminate cytology at FNA. The measurement of serum TSH levels represents an easily performed additional tool for decision-making in patients with indeterminate cytological findings.

scholarly journals A study of association between serum thyroid stimulating hormone concentration and thyroid cancer and also to assess whether serum thyroid stimulating hormone levels are of value in predicting malignancy in patients with thyroid swelling

2021 ◽  
Author(s):  
Benny Bright ◽  
Joe Mathew ◽  
Jacob P. Thomas ◽  
Robinson George
Keyword(s):  
Thyroid Cancer ◽  
Papillary Carcinoma ◽  
Thyroid Nodules ◽  
Malignant Tumors ◽  
Independent Predictor ◽  
Medical Science ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Malignancy ◽  
Serum Tsh ◽  
Stimulating Hormone

Background: Thyroid neoplasm includes both benign and malignant tumors arising in the thyroid gland. Although thyroid cancer accounts for less than 1% of all cancers, the challenge to clinicians is to identify the minority of thyroid nodules that harbor malignancy. There are a number of well-established predictors of malignancy in thyroid nodules. More recently a few studies have suggested that higher concentration of thyroid stimulating hormone (TSH), even within the normal range are associated with subsequent diagnosis of thyroid cancer in patients with thyroid nodules and even higher serum TSH levels have been found associated with advanced stages of thyroid cancer. Methods: A prospective study was conducted on 220 cases without overt thyroid dysfunction attending Department of general surgery, Pushpagiri institute of medical science, Thiruvalla.  Results: In our study incidence of malignancy of thyroid carcinoma was highest in patients with serum TSH concentrations, in range of 3.5 mIU/l-5.25 mIU/l, 55 patients out of 220 patients. Individually, incidence of papillary carcinoma (PC) (36/55 patients), follicular carcinoma (FC) (17/55 patients) and Hurthle cell carcinoma (HCC) (2/55 patients) were more in patients with higher TSH. So, from the study it can be clearly state that elevated TSH can be used as an independent predictor of thyroid malignancy. Higher TSH values are associated with papillary thyroid carcinoma.Conclusions: An elevated TSH can be used as an independent predictor of thyroid malignancy, especially for anticipating a probability of papillary carcinoma of thyroid.  

scholarly journals Comparative study on association between serum TSH concentration and Thyroid cancer

2017 ◽  
Vol 4 (8) ◽  
pp. 2800
Author(s):  
Prasad C. ◽  
Supreet Kumar ◽  
Tej Tej Y.
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Tertiary Care ◽  
Follicular Carcinoma ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Thyroid Malignancy ◽  
Tertiary Care Centre ◽  
Serum Tsh ◽  
Tsh Levels

Background: In India, thyroid cancer accounts for less than 1% of all malignancies (2% of women and 0.5% of men). Thyroid cancer is responsible for 6 deaths per 1 million persons annually. Serum TSH is a well-established growth factor for thyroid nodules, however its role in thyroid malignancy is inconclusive hence this study was conducted with the objective to determine the association between serum Thyroid stimulating hormone (TSH) concentrations with thyroid carcinoma.Methods: Case control study was conducted in a tertiary care centre. 120 Benign and malignant thyroid subjects respectively were included in the study. Newly diagnosed and record based data collection was done. Measurements of serum TSH concentrations were performed by automated immune chemiluminescent assay. Data was analyzed using SPSS 22 version software, Chi-square test was used as test of significance for qualitative data, p value of <0.05 was considered as statistically significant.Results: Majority of them were females in the age group 26 to 40 years in both the groups and were diagnosed to have solitary thyroid nodule. In malignant thyroid nodules 51.7% were diagnosed to have follicular carcinoma, 46.7% had papillary carcinoma and 1.7% were diagnosed to have Hurthle cell carcinoma. Significant association was observed between TSH levels and diagnosis of thyroid lesions. TSH was raised (>4mIU/L) in 46.6% of malignant nodules and in 15% of benign nodules. Raised TSH had an odds ratio of 4.958 for Thyroid malignancy compared to benign nodulesConclusions: Higher TSH levels were associated with Thyroid malignancy and the risk of malignancy rises in parallel with serum TSH within normal range, and high levels of serum TSH concentrations was associated with advanced stage of thyroid cancer. 

scholarly journals Serum TSH and Risk of Papillary Thyroid Cancer in Nodular Thyroid Disease

2012 ◽  
Vol 97 (4) ◽  
pp. 1134-1145 ◽  
Author(s):  
Emilio Fiore ◽  
Paolo Vitti
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Disease ◽  
Differentiated Thyroid Cancer ◽  
Nodular Goiter ◽  
Papillary Thyroid ◽  
Thyroid Malignancy ◽  
The Relationship ◽  
Serum Tsh

Context: TSH is the main factor involved in the control of proliferation of thyrocytes. Recently, a strong relationship between serum TSH and risk of thyroid malignancy has been reported. Objectives: The aim was to review published papers about the relationship between serum TSH and frequency of differentiated thyroid cancer. Evidence Acquisition: PubMed was used to identify studies focused on the relationship between TSH and differentiated thyroid cancer. Evidence Synthesis: In patients with nodular thyroid disease, the risk of thyroid malignancy increases with serum TSH, and even within normal ranges, higher TSH values are associated with a higher frequency and more advanced stage of thyroid cancer. The likelihood of papillary thyroid carcinoma is reduced when TSH is lower, as in thyroid autonomy, and increased when TSH is higher, as in thyroid autoimmunity. Treatment with l-thyroxine (LT4), which reduces serum TSH, is associated with significantly lower risk of developing clinically detectable thyroid cancer. Conclusions: TSH plays a key role in the development of clinically detectable thyroid cancer, and LT4 treatment reduces the risk of thyroid malignancy in patients with nodular thyroid disease. According to the guidelines of the main scientific societies, LT4 therapy is not currently recommended for the treatment of patients with nodular goiter. Even if the available data are not sufficient to advise LT4 treatment in all patients with nodular goiter with the aim of reducing the risk of papillary thyroid carcinoma, we propose that this indication should be reconsidered, taking into account recent evidence reported in the literature.

scholarly journals Serum Thyrotropin Concentration as a Novel Predictor of Malignancy in Thyroid Nodules Investigated by Fine-Needle Aspiration

2006 ◽  
Vol 91 (11) ◽  
pp. 4295-4301 ◽  
Author(s):  
K. Boelaert ◽  
J. Horacek ◽  
R. L. Holder ◽  
J. C. Watkinson ◽  
M. C. Sheppard ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Tertiary Care ◽  
Needle Aspiration ◽  
Thyroid Malignancy ◽  
Care Clinic ◽  
Fine Needle ◽  
Increased Risk ◽  
Risk Of Malignancy ◽  
Serum Tsh

Abstract Context: Thyroid nodules and goiter are common, and fine-needle aspiration biopsy (FNAB) is the first investigation of choice in distinguishing benign from malignant disease. Objective: The objective of the study was to assess whether simple clinical and biochemical parameters can predict the likelihood of thyroid malignancy in subjects undergoing FNAB. Design: The design was a prospective cohort. Setting: The study was conducted at a single secondary/tertiary care clinic. Participants: One thousand five hundred consecutive patients without overt thyroid dysfunction (1304 females and 196 males, mean age 47.8 yr) presenting with palpable thyroid enlargement between 1984 and 2002 were evaluated by FNAB of the thyroid. Intervention(s): There were no interventions. Main Outcome Measures: Goiter type was assessed clinically and classified as diffuse in 183, multinodular in 456, or solitary nodule in 861 cases. Serum TSH concentration at presentation was measured in a sensitive assay in patients presenting after 1988 (n = 1183). The final cytological or histological diagnosis was determined after surgery (n = 553) or a minimum 2-yr clinical follow-up period (mean 9.5 yr, range 2–18 yr). Results: The overall sensitivity and specificity of FNAB in predicting malignancy were 88 and 84%, respectively. The risk of diagnosis of malignancy rose in parallel with the serum TSH at presentation, with significant increases evident in patients with serum TSH greater than 0.9 mU/liter, compared with those with lower TSH. Binary logistic regression analysis revealed significantly increased adjusted odds ratios (AORs) for the diagnosis of malignancy in subjects with serum TSH 1.0–1.7 mU/liter, compared with TSH less than 0.4 mU/liter [AOR 2.72, 95% confidence interval (CI) 1.02–7.27, P = 0.046], with further increases evident in those with TSH 1.8–5.5mU/liter (AOR 3.88, 95% CI 1.48–10.19, P = 0.006, compared with TSH &lt; 0.4 mU/liter) and greater than 5.5 mU/liter (AOR 11.18, 95% CI 3.23–8.63, P &lt; 0.001, compared with TSH &lt; 0.4 mU/liter). Males (AOR 1.8, 95% CI 1.04–3.1, P = 0.04), younger patients (AOR 1.1, 95% CI 1.01–1.15, P = 0.025), and those with clinically solitary nodules (AOR 2.53, 95% CI 1.5–4.28, P = 0.001) were also at increased risk. Based on these findings, a formula to predict the risk of the diagnosis of thyroid malignancy in individual patients, taking into account their gender, age, goiter type determined clinically, and serum TSH, was calculated. Conclusions: The risk of malignancy in a thyroid nodule increases with serum TSH concentrations within the normal range. In addition to patient’s gender, age, and goiter type, the serum TSH concentration at presentation is an independent predictor of the presence of thyroid malignancy. We propose that these simple clinical and biochemical factors can serve as an adjunct to FNAB in predicting risk of malignancy.

Abstract #1221 Real World Experience with Thyroseq V3 Genomic Classifier in Thyroid Nodules with Indeterminate Cytology: Results of Testing of the First 3,783 Consecutive Samples

2018 ◽  
Vol 24 ◽  
pp. 316
Author(s):  
Yuri Nikiforov ◽  
Steven P. Hodak ◽  
Susan Mandel ◽  
Zubair Baloch ◽  
Daniel Kuriloff ◽  
...  
Keyword(s):  
Real World ◽  
Thyroid Nodules ◽  
Indeterminate Cytology

Graves'-Basedow disease in pregnancy

2015 ◽  
Vol 54 (03) ◽  
pp. 106-111 ◽  
Author(s):  
S. L. Andersen ◽  
P. Laurberg
Keyword(s):  
Side Effects ◽  
Birth Defects ◽  
Thyroid Dysfunction ◽  
National Study ◽  
Antithyroid Drugs ◽  
Upper Limit ◽  
Special Concern ◽  
Maternal Thyroid ◽  
Toxic Reactions ◽  
Serum Tsh

SummaryThyroid hormones are essential development factors and maternal thyroid dysfunction may cause pregnancy complications and diseases in the fetus/child. In the present review we discuss new data on the incidence of Graves'-Basedow disease (GBD) in and around pregnancy, and how hyperthyroidism may affect the risk of spontaneous abortion and stillbirth.A special concern in pregnant women is the potential side effects from the use of antithyroid drugs (ATDs). One type of side effects is the allergic/toxic reactions to the drugs, which seem to be similar in and outside pregnancy, and another is that ATDs tend to over treat the fetus when the mother with GBD is made euthyroid. To avoid fetal hypothyroidism, the lowest possible ATD dose should be used to keep maternal thyroid function at the upper limit of normality with low serum TSH. Birth defects after the use of methimazole (MMI) (or its prodrug carbimazole) have been considered to be very rare, and no risk has previously been associated with the use of propylthiouracil (PTU). However, a recent Danish national study found that 1/30 of children exposed to MMI in early pregnancy had birth defects associated with this, and many defects were severe. PTU exposure was associated with defects in 1/40, and these defects were less severe. Proposals are given on how to reduce the risk of ATD associated birth defects.

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