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 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 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 

DEVELOPMENT AND INTERNAL VALIDATION OF A PREDICTIVE MODEL FOR INDIVIDUAL CANCER RISK ASSESSMENT FOR THYROID NODULES

2020 ◽  
Vol 26 (10) ◽  
pp. 1077-1084
Author(s):  
Florentino Carral San Laureano ◽  
Juan Jesús Fernández Alba ◽  
José Manuel Jiménez Heras ◽  
Ana Isabel Jiménez Millán ◽  
Mariana Tomé Fernández-Ladreda ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Confidence Interval ◽  
Predictive Model ◽  
Thyroid Nodules ◽  
Cross Validation ◽  
Thyroid Stimulating Hormone ◽  
Individual Risk ◽  
Risk Of Malignancy ◽  
The Individual ◽  
Stimulating Hormone

Objective: The objective of this study was to develop and validate a predictive model for the assessment of the individual risk of malignancy of thyroid nodules based on clinical, ultrasound, and analytic variables. Methods: A retrospective case-control study was carried out with 542 patients whose thyroid nodules were analyzed at our endocrinology department between 2013 and 2018 while undergoing treatment for thyroidectomy. Starting with a multivariate logistic regression analysis, which included clinical, analytic, and ultrasound variables, a predictive model for thyroid cancer (TC) risk was devised. This was then subjected to a cross-validation process, using resampling techniques. Results: In the final model, the independent predictors of the risk of malignancy were: being male, age of the extremes, family history of TC, thyroid-stimulating hormone level >4.7 μU/L, presence of autoimmune thyroiditis, solid consistency, hypoechogenicity, irregular or microlobed borders, nodules that are taller than they are wide, microcalcifications, and suspicious adenopathy. With a cut-off point of 50% probability of thyroid cancer, the predictive model had an area under the receiver operating characteristic curve of 0.925 (95% confidence interval 0.898 to 0.952). Finally, using the 10-fold cross-validation method, the accuracy of the model was found to be 88.46%, with a kappa correlation coefficient of 0.62. Conclusion: A predictive model for the individual risk of malignancy of thyroid nodules was developed and validated using clinical, analytic, and ultrasound variables. An online calculator was developed from this model to be used by clinicians to improve decision-making in patients with thyroid nodules. Abbreviations: ATA = American Thyroid Association; CI = confidence interval; FNA = fine needle aspiration; TC = thyroid cancer; TSH = thyroid-stimulating hormone

scholarly journals Assessment of Thyroid Peroxidase Antibody And Thyroid Stimulating Hormone In First Trimester Of Pregnancy

2013 ◽  
Vol 12 (2) ◽  
pp. 164-171
Author(s):  
Nishat Un Nahar ◽  
Zeba Un Naher ◽  
Md. Ashanul Habib ◽  
Forhadul Hoque Mollah
Keyword(s):  
Preterm Birth ◽  
Post Partum ◽  
Medical Science ◽  
First Trimester ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
First Trimester Of Pregnancy ◽  
Serum Tsh ◽  
Stimulating Hormone

Introduction: Maternal thyroid dysfunction during pregnancy has been associated with a number of adverse outcomes, like preterm birth, placental abruption, foetal death and impaired neurological development in the child. Simultaneously the presence of antibody to thyroid peroxidase results miscarriage, preterm birth and maternal post partum thyroid disease. Post partum thyroiditis is closely associated with the presence of antibodies to thyroid peroxidase (TPO). Indeed if a pregnant woman is positive for TPO antibodies early in pregnancy, her chances of developing post partum thyroiditis is 30-52%. Objective: To find out the level of TPO-Ab and thyroid status in first trimester of pregnancy. Method: The cross sectional study was designed in Department of Biochemistry, BSMMU, Dhaka. Following inclusion and exclusion criteria 200 sample was selected by purposive and convenient sampling. The study parameters were- thyroid peroxidase antibody (TPO-Ab); serum thyroid stimulating hormone (TSH); serum free thyroxin (FT4). Results: 43 (21.5%) pregnant women of first trimester was found to be TPO-Ab positive, among these 43 subjects 16 (8.0%) had raised TSH i.e. >2.5 mIU/L and 27 had TSH level <2.5 mIU/L. Low serum FT4 was in 9 (4.5%) subjects. The study revealed that, there was a significant positive correlation between positive TPO-Ab (>12 IU/mL) and serum TSH level of study subjects and there was negative correlation between serum TSH (>2.5 mIU/L) and serum FT4 in study subjects. Conclusion: TPO-Ab positivity in first trimester of pregnancy and TPOAb positivity was associated with higher TSH and low FT4 level. Bangladesh Journal of Medical Science Vol. 12 No. 02 April’13 Page 164-170 DOI: http://dx.doi.org/10.3329/bjms.v12i2.14945

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 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 Impact of Adipocytokines-Leptin and Adiponectin on Thyroid Stimulating Hormone among Hypothyroid Patients

2013 ◽  
Vol 5 (2) ◽  
pp. 67-72
Author(s):  
P Eshita ◽  
B Dharani Priya ◽  
G Sudhakar ◽  
G Paddaiah
Keyword(s):  
Metabolic Diseases ◽  
Normal Values ◽  
Medical Science ◽  
Thyroid Stimulating Hormone ◽  
Adiponectin Concentration ◽  
Metabolic Functions ◽  
Metabolic Activities ◽  
Hypothyroid Patients ◽  
Serum Tsh ◽  
Stimulating Hormone

Background: Adipocytokines, secreted from the adipose tissues have profound effect on complex metabolic and endocrine functions. Among them, leptin and adiponectin are the most recognized molecules which influence body homeostasis and metabolism. Moreover, patients with thyroid disease usually exhibit disturbances of these metabolic activities. Thus adipocytokines and thyroid hormones may influence similar aspects of metabolic functions. Objective: The main objective of current study was to evaluate the association and impact of leptin and adiponectin on thyroid stimulating hormone (TSH) among hypothyroid patients. Materials and Methods: For the present study a total 350 individuals were enlisted, out of which 200 were hypothyroid patients and 150 age and sex matched healthy controls aged ≥ 12 years. The serum TSH, leptin and adiponectin concentration were measured by CLIA method and results were computed by statistical methods such as mean, standard deviation, standard error and correlation using MS-Excel 2007. Result: Our data showed that hypothyroidism was more prevalent in the age group 30-50(62%) and an elevated TSH level was observed with advancing age among the patients as compared to controls. The inverse relation of leptin and adiponectin has been seen among the patients. When patients were compared with controls, they were with normal values which were in the range of standardized lab values leptin (3.7-13ng/dl) and adiponectin (5-10μg/ml). Conclusion: In conclusion, our data interpreted variations in the level of leptin and adiponectin among the hypothyroid individuals with high TSH level. As abnormal levels of these adipocytokines indicates the risk for other metabolic diseases like cardiovascular disease, obesity etc. DOI: http://dx.doi.org/10.3126/ajms.v5i2.8789 Asian Journal of Medical Science, Volume-5(2) 2014: 67-72

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