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 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 Prevalence of anti-thyroid peroxidase antibodies in the first trimester pregnancy and its impact on maternal and fetal outcomes in a tertiary care centre in Bangalore

2021 ◽  
Vol 8 (2) ◽  
pp. 182-187
Author(s):  
Shruthi H S ◽  
Nalini Arunkumar ◽  
Ravi N Patil
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
First Trimester ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Thyroid Peroxidase ◽  
American Thyroid Association ◽  
Tertiary Care Centre ◽  
Mother And Child ◽  
Tsh Levels

: Hypothyroidism during pregnancy has an adverse effect on both mother and child. The maternal and foetal risk is higher in TPOAb (Thyroid peroxidase antibody) positive women compared to women with negative TPO Ab. The recent ATA (American Thyroid Association) guidelines recommend that pregnant women with TSH (Thyroid Stimulating Hormone) concentration above 2.5mU/L should be evaluated for TPOAb status and LT4(levothyroxine) treatment should be considered with TSH values between 2.5mU/L and 4.0mU/L only when TPOAb status is positive.: All the pregnant women booked in first trimester underwent testing for TSH levels and subsequently for anti TPO Ab if TSH levels were between 2.5-4 mIU/ml. The hospital based prevalence of women with anti TPO Ab positive status was determined. These pregnancies were followed till term and the maternal and foetal complications associated with TPO Ab positive and negative status were compared. Total of 400 pregnant women were included. The hospital prevalence of women with anti TPO antibodies in first trimester of pregnancy with TSH values between 2.5- 4 mIU/ml was found to be 23.5%. Anti TPO antibody positive status was significantly more associated with antenatal complications especially GDM and IUGR as compared to patients with anti TPO antibody negative status (47.8% v/s 23.2%, p value 0.001).: Women with TPO Ab positive status are to be vigilantly monitored for early detection and management of various antenatal complications. Determining anti TPO Ab status helps in avoiding unnecessary treatment of the women with TPO Ab negative status and TSH between 2.5-4mIU/ml.

scholarly journals Preoperative thyroid-stimulating hormone associated risk of differentiated thyroid cancer in patients with thyroid nodules

2021 ◽  
Vol 67 (3) ◽  
pp. 85-91
Author(s):  
Al Essa M
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Thyroid Nodules ◽  
Conditional Logistic Regression ◽  
Care Center ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Normal Range ◽  
Tsh Levels ◽  
Stimulating Hormone

In an assessment of risk for differentiated thyroid cancer (DTC) in individuals with human papillary thyroid cancer (PTC) and thyroid nodules a cohort prospective study was undertaken to establish the significance of preoperative thyroid-stimulating hormone (TSH) levels. Confirmed histologically PTC cases in one tertiary care center, and matched healthy individuals were tested for TSH, T3, T4 and T4 free total. The ORs and 95% confidence intervals have been calculated using conditional logistic regression models (CI). The blood TSH levels were related to the higher risk of PTC for men (OR,0,09; 95% Ci, 04–0,21, 95% CI and women) compared with the middle tertile of the TSH levels in the normal range (OR,0,07; 95 percent CI, 0,04–0,1). Over the normal range of TSH levels, an elevated PTC risks were connected amongst women (OR 0,09; 95% CI, 0,04–0,21) but not amongst men (OR,0,07; 95% CI, 0,04–0,1). With an increase in TSH level in the normal range between men and women, the risk for PTC reduced (Ptrend=0.041 and 0.0001). The risk of PTC related to TSH levels has been dramatically elevated above  the normal range for men  and TSH values below the normal range for women.

scholarly journals Observational study on association between serum thyroid stimulating hormone and thyroid malignancy

2017 ◽  
Vol 4 (6) ◽  
pp. 2002
Author(s):  
Arun K. ◽  
Santhosh Nayak K. ◽  
Suhas Gowda
Keyword(s):  
Thyroid Cancer ◽  
Observational Study ◽  
Thyroid Nodules ◽  
Thyroid Stimulating Hormone ◽  
Normal Range ◽  
Advanced Stages ◽  
Test Of Significance ◽  
Serum Tsh ◽  
Tsh Levels ◽  
Stimulating Hormone

Background: Thyroid cancer is the most common endocrine malignancy and its incidence continues to rise. Thyroid carcinoma in most cases presents clinically as a solitary nodule or as a dominant nodule within a multinodular thyroid gland. There are a number of well-established of predictors of malignancy in thyroid nodules. More recently studies have suggested that higher concentration of 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. Objectives were to determine the association between serum thyroid stimulating hormone (TSH) concentration and thyroid cancer and to estimate serum TSH levels in different stages of thyroid malignancy.Methods: A hospital based observational study was conducted in a tertiary care hospital for a period of 2 year. 120 patients presenting with thyroid nodule without an overt thyroid dysfunction during the study period were included in the study. Chi-square was used as test of significance. Independent t test was the test of significance for quantitative data between two groups.Results: In the study majority of thyroid cancer patients (106 out of 120) had serum TSH concentrations ranging 1.71mIU/L-5.5mIU/L i.e. within normal range but towards higher range. Mean serum TSH concentrations was significantly high in advanced stages of carcinoma. Mean Serum TSH was high in Stage III and Stage IV (5.17±1.36mIU/l) compared to stage I and II (4.03±1.87mIU/l).Conclusions: The study concludes that TSH levels were in the Upper reference range in majority of thyroid malignancies and high levels of serum TSH concentrations associated with advanced stage of thyroid cancer.

scholarly journals Utility of pre-operative serum thyroid stimulating hormone in predicting thyroid malignancy

2017 ◽  
Vol 4 (8) ◽  
pp. 2796
Author(s):  
Arun K. ◽  
Santhosh Nayak K. ◽  
Suhas Gowda
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Thyroid Stimulating Hormone ◽  
Multinodular Goitre ◽  
Advanced Stages ◽  
Test Of Significance ◽  
Thyroid Malignancies ◽  
Serum Tsh ◽  
Tsh Levels ◽  
Stimulating Hormone

Background: Thyroid cancer is the most common endocrine malignancy and its incidence continues to rise. Thyroid carcinoma in most cases presents clinically as a solitary nodule or as a dominant nodule within a multinodular thyroid gland. There are a number of well-established of predictors of malignancy in thyroid nodules. More recently studies have suggested that higher concentration of 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. The objective of this study was to determine the serum thyroid stimulating hormone (TSH) concentration before surgery in different thyroid malignancies and to compare serum TSH concentration after surgery in thyroid malignancyMethods: A hospital based observational study was conducted in a tertiary care hospital for a period of 2 year. 120 patients presenting with thyroid nodule without an overt thyroid dysfunction during the study period were included in the study. Chi-square was used as test of significance. Independent t test was the test of significance for quantitative data between two groups.Results: Mean serum TSH was higher in thyroid malignancies and significant difference was observed between solitary and multinodular goitre. Mean serum TSH concentrations was significantly high in papillary carcinoma and advanced stages of carcinoma. Mean serum TSH was high in stage III and stage IV (5.17±1.36 mIU/l) compared to stage I and II (4.03±1.87 mIU/l).Conclusions: The study concludes that TSH levels were high in thyroid malignancies arising from multinodular goitre, majority of thyroid malignancies had high levels of serum TSH concentrations and TSH was high with advanced stage of thyroid cancer 

scholarly journals Body Mass Index (BMI) dependent effect of thyroid stimulating hormone (TSH) and gonadotropins on ovarian reserve markers in the secondary infertile women at fertile age.

2021 ◽  
Author(s):  
Haroon Latif Khan ◽  
Komal Fatima ◽  
Shahzad Bhatti ◽  
Sammar Nathanial ◽  
Hooria Younus
Keyword(s):  
Ovarian Reserve ◽  
Medical Condition ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Reproductive Age ◽  
P Value ◽  
Cross Sectional ◽  
Infertile Women ◽  
Ovarian Reserve Markers ◽  
Tsh Levels

Abstract Background: Infertility is a medical condition when a couple fails to conceive after having regular unprotected intercourse without the use of any contraceptive, it a complex global health issue that can be primary with no previous conception or secondary with one or more previous conceptions. A number of anomalies in the reproductive track govern the state of infertility in female of reproductive age.Materials and Methods: The study was conducted on 100 secondary infertile women based on BMI groups {Normal 18-23.9 kg/m2 (N=35) and Overweight 24-27 kg/m2 (N=65)}, attending tertiary care infertility center: Lahore Institute of Fertility and Endocrinology, Hameed Latif Hospital. The present analytical cross sectional study was conducted to assess the BMI based combinatorial effect of gonadotropins with thyrotropin and ovarian reserve markers in secondary infertile women. Serum hormonal levels of TSH, LH, FSH and AMH were measured by using Roche electrochemiluminescence immunoassay (ECLIA) and AFC was recorded by transvaginal ultrasonography. The results were statistically analyzed by Spearman correlation test using XLSTAT, considered significant at p-value <0.05. Results: A total of 18% of secondary infertile women with normal BMI were found to have a lower serum TSH levels (<0.27µIU/ml) which can be characterized as hyperthyroidism as compared to overweight population. A strong significant positive correlation was found in the TSH, age and BMI, however, these factors were found to be negatively correlated with AMH and AFC. Gonadotropins level was increased with increase in TSH levels among participants with normal BMI but decreased with TSH escalation values among overweight population. Conclusion: TSH was found to be one of the most important diagnostic factors of infertility must be monitored in relation with other parameters (AMH, AFC, FSH, and LH) in order to spot instigation point, as it directly acts upon ovulation surge by controlling gonadotropins related actions on ovarian reserve. Weight should also be assessed regularly with age to minimize the infertility issues.

scholarly journals The role of thyroid stimulating hormone in the timing of thyroxin supplement after thyroid operations

2021 ◽  
Vol 8 (2) ◽  
pp. 44-53
Author(s):  
Basil A. S. Al-Khayyat ◽  
Anmar Jumaa Ghali ◽  
Berq J. Hadi Al-Yasseri
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Thyroid Nodules ◽  
Thyroid Stimulating Hormone ◽  
Suppressive Therapy ◽  
Hashimoto's Thyroiditis ◽  
Histopathological Results ◽  
Serum Tsh ◽  
Tsh Levels ◽  
Stimulating Hormone

Thyroid Stimulating Hormone (TSH) levels can be measured accurately down to a very low serum concentration with an immunoassay. When the serum TSH level is in the normal range, measuring the T3 and T4 levels is redundant. The objective of this study is to study the relation of TSH levels postoperatively in thyroid surgeries with the timing for thyroxin treatment as a supplemental and suppressive therapy. A prospective cohort study was done on 84 patients underwent thyroid operations in Al-Yarmouk Teaching Hospital from March 2010 through November 2012. Patients underwent different thyroid operations (lobectomy, subtotal thyroidectomy and total thyroidectomy) for different thyroid pathology. Later, they were followed up by TSH assay in periods of 2, 4, 6 and 12 months postoperatively. Variables were compared by using the analysis of variance, ANOVA test. P – values equal or less than 0.05 and 0.01 were considered to be statistically significant and highly significant, respectively. The mean age of patients was 43.30 ± 10.19 years. The females made the vast majority of study sample (85.7%). Patients were divided into six groups: simple colloid goiters (17 patients), multinodular goiters (32 patients), solitary thyroid nodules (11 patients), Hashimoto’s thyroiditis (8 patients), Graves’ disease (8 patients) and papillary and follicular carcinomas (8 patients). The study revealed that all patients with malignant thyroid nodules (i.e. those with total thyroidectomies) and the vast majority of patients with Hashimoto’s thyroiditis were in definite need for thyroxin treatment post-operatively. Other patients were variable in their need and timing of treatment according to the histopathological results and the type of operations. In conclusion; measurement of TSH level postoperatively is a good indicator for need of thyroxin treatment and for dose adjustment with the help of pathological results and the type of surgery.

scholarly journals WOMEN IN CANCER THEMATIC REVIEW: Thyroid-stimulating hormone in thyroid cancer: does it matter?

2016 ◽  
Vol 23 (11) ◽  
pp. T109-T121 ◽  
Author(s):  
Hannah Nieto ◽  
Kristien Boelaert
Keyword(s):  
Thyroid Cancer ◽  
High Risk ◽  
Thyroid Nodules ◽  
Cancer Recurrence ◽  
Needle Aspiration ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Cells ◽  
Invasive Approach ◽  
Serum Tsh ◽  
Stimulating Hormone

Differentiated thyroid cancer is the most common endocrine malignancy and the incidence is increasing rapidly worldwide. Appropriate diagnosis and post-treatment monitoring of patients with thyroid tumours are critical. Fine needle aspiration cytology remains the gold standard for diagnosing thyroid cancer, and although there have been significant refinements to this technique, diagnostic surgery is often required for patients suspected to have malignancy. Serum thyroid-stimulating hormone (TSH) is higher in patients with malignant thyroid nodules than in those with benign disease, and TSH is proportionally increased in more aggressive tumours. Importantly, we have shown that the pre-operative serum TSH concentration independently predicts the presence of malignancy in subjects presenting with thyroid nodules. Establishing the use of TSH measurements in algorithms identifying high-risk thyroid nodules in routine clinical practice represents an exciting, cost-efficient and non-invasive approach to optimise thyroid cancer diagnosis. Binding of TSH to receptors on thyrocytes stimulates a number of growth promoting pathways both in normal and malignant thyroid cells, and TSH suppression with high doses of levothyroxine is routinely used after thyroidectomy to prevent cancer recurrence, especially in high-risk tumours. This review examines the relationship between serum TSH and thyroid cancer and reflects on the clinical potential of TSH measurements in diagnosis and disease monitoring.

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 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.

Sign in / Sign up

Export Citation Format

Share Document