To Study and Compare the Relationship between Preoperative Serum TSH and Frequency of Differentiated Thyroid Cancer

There is mounting evidence that the serum concentration of TSH is an independent predictor for the diagnosis of thyroid malignancy in patients with nodular thyroid disease. Furthermore, preoperative serum TSH concentrations are higher in patients with more aggressive tumours, suggesting a potential role for TSH in the progression of differentiated thyroid cancer. Based on these observations, patients with higher serum TSH concentrations and borderline cytological results may require more aggressive investigation and treatment when compared with those with lower baseline TSH levels. The mechanisms underlying the finding of higher serum TSH in patients with thyroid cancer remain unexplained. In this issue of Endocrine-Related Cancer, Fiore et al. have analysed the relationship between serum TSH and diagnosis of papillary thyroid cancer in 10 178 patients with nodular thyroid disease who were investigated by fine-needle aspiration biopsy. They found significantly higher TSH concentrations in patients who were subsequently diagnosed with thyroid cancer compared with those with benign disease. In addition, they found that the development of autonomous thyroid function (TSH<0.4 μU/ml) was associated with a reduction in the risk of papillary thyroid carcinoma. In this commentary, the evidence regarding the association between serum TSH and thyroid cancer is discussed placing these new findings into context.

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Pattern analysis for prognosis of differentiated thyroid cancer according to preoperative serum thyrotropin levels

Scientific Reports ◽

10.1038/s41598-021-01898-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hosu Kim ◽

Jaehoon Jung ◽

Young-Seok Cho ◽

Joon Young Choi ◽

Hyunju Park ◽

...

Keyword(s):

Thyroid Cancer ◽

Distant Metastasis ◽

Tumor Size ◽

Primary Tumor ◽

Differentiated Thyroid Cancer ◽

Pattern Analysis ◽

Primary Tumor Size ◽

Preoperative Serum ◽

Serum Tsh ◽

Tsh Levels

AbstractSerum thyrotropin (TSH) level after thyroid surgery affects the prognosis of differentiated thyroid cancer (DTC). However, the effects of preoperative serum TSH levels on the prognosis of DTC remain contradictory. In this study, to better understand the relationship between preoperative TSH levels and the prognosis of DTC, we performed pattern analysis of prognostic factors of DTC according to preoperative serum TSH levels. We retrospectively reviewed the clinical records of patients who were diagnosed and treated for DTC at the Samsung Medical Center, between 1994 and 2016. We reviewed preoperative serum TSH levels and performed a pattern analysis with prognostic risk factors for DTC. For pattern analysis, TSH was divided into 10 groups of equal fractions (TSH decile). We found a linear association between preoperative TSH levels and extra-thyroidal extension and lymph node metastasis. However, primary tumor size and initial distant metastasis showed a bimodal peak, which was similar to the pattern of overall and disease-specific death. We found that preoperative TSH range which showed the lowest mortality rate was about 0.8 to 1.59 mIU/L, which are slightly lower normal TSH levels. Although there was no linear trend, the primary tumor size, initial distant metastasis, and mortality of DTC were closely related with preoperative TSH decile and they showed a bimodal pattern. The results obtained in this study provide additional information for understanding the association between preoperative TSH levels and DTC prognosis.

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

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2011-2735 ◽

2012 ◽

Vol 97 (4) ◽

pp. 1134-1145 ◽

Cited By ~ 104

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.

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Relationship between Thyroglobulin and Tumor Detectabilily with Thallium-201 in Differentiated Thyroid Cancer

Nuklearmedizin ◽

10.1055/s-0038-1632238 ◽

2000 ◽

Vol 39 (01) ◽

pp. 10-15 ◽

Cited By ~ 1

Author(s):

S. P. Müller ◽

Ch. Reiners ◽

A. Bockisch ◽

Katja Brandt-Mainz

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Roc Analysis ◽

Tsh Suppression ◽

Significant Difference ◽

Test Specificity ◽

The Relationship ◽

Tumor Scintigraphy ◽

Tsh Stimulation

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.

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The role of preoperative serum thyroglobulin values in the diagnosis of differentiated thyroid cancer

Endocrine Abstracts ◽

10.1530/endoabs.49.ep1370 ◽

2017 ◽

Author(s):

Blertina Dyrmishi ◽

Taulant Olldashi ◽

Ema Lumi ◽

Entela Puca ◽

Dorina Ylli ◽

...

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Serum Thyroglobulin ◽

Preoperative Serum

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Potential Impact of BMI on the Aggressiveness of Presentation and Clinical Outcome of Differentiated Thyroid Cancer

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz312 ◽

2019 ◽

Vol 105 (4) ◽

pp. e1124-e1134

Author(s):

Antonio Matrone ◽

Giovanni Ceccarini ◽

Marianna Beghini ◽

Federica Ferrari ◽

Carla Gambale ◽

...

Keyword(s):

Risk Factor ◽

Thyroid Cancer ◽

Clinical Outcome ◽

Differentiated Thyroid Cancer ◽

Normal Weight ◽

American Thyroid Association ◽

131I Treatment ◽

Therapeutic Attitude ◽

The Relationship

Abstract Background Obesity is a risk factor for several cancers, including differentiated thyroid cancer (DTC). Moreover, it has also been investigated as a potential risk factor for aggressiveness of DTC, but the data gathered so far are conflicting. The aim of our study was to evaluate the relationship between body mass index (BMI), aggressiveness of DTC at diagnosis, and clinical outcome. Methods We evaluated 1058 consecutive DTC patients treated with total thyroidectomy and enrolled at the time of first radioactive iodine (131I) treatment. Patients were divided into 4 groups based on their BMI: underweight (< 18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), and obese (≥ 30 kg/m2). Histological aggressiveness of DTC at the time of diagnosis and clinical outcome according to 2015 American Thyroid Association (ATA) guidelines were evaluated. Results No differences in histological features, ATA risk of recurrence, activity of 131I administered and prevalence of 131I avid metastatic disease after first131I treatment, have been demonstrated among the groups. Furthermore, at the end of follow up (median = 5.7 years), no differences were evident in the number of further treatments performed as well as in the clinical response. Conclusions In our study group of Caucasian subjects, we could not demonstrate any association between BMI and aggressiveness of DTC, neither at the time of diagnosis nor during follow-up. These data indicate that postsurgical assessment and therapeutic attitude for treatment and follow-up of DTC should be based on the class of risk applied to the general population, with no concern for BMI.

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Preoperative Serum Thyroglobulin and Its Correlation with the Burden and Extent of Differentiated Thyroid Cancer

Cancers ◽

10.3390/cancers12030625 ◽

2020 ◽

Vol 12 (3) ◽

pp. 625

Author(s):

Hosu Kim ◽

So Young Park ◽

Jun-Ho Choe ◽

Jee Soo Kim ◽

Soo Yeon Hahn ◽

...

Keyword(s):

Thyroid Cancer ◽

Primary Tumor ◽

Differentiated Thyroid Cancer ◽

Medical Center ◽

Distant Metastases ◽

Predictive Biomarker ◽

Tumor Burden ◽

Serum Thyroglobulin ◽

Preoperative Serum ◽

Clinical Records

Lymph node metastasis (LNM) in differentiated thyroid cancer (DTC) is usually detected with preoperative ultrasonography; however, this has limited sensitivity for small metastases, and there is currently no predictive biomarker that can help to inform the extent of surgery required. We evaluated whether preoperative serum thyroglobulin levels can predict tumor burden and extent. We retrospectively reviewed the clinical records of 4029 DTC cases diagnosed and treated at a Samsung Medical Center between 1994 and 2016. We reviewed primary tumor size, number and location of LNM, and presence of distant metastases to reveal relationships between tumor burden and extent and preoperative serum thyroglobulin levels. We found a linear association between increasing preoperative thyroglobulin levels, the size of the primary tumor, and the number of LNM (r = 0.34, p < 0.001, r = 0.20, p < 0.001, respectively). Tumor extent also increased with each decile of increasing preoperative thyroglobulin level (r = 0.18, p < 0.001). Preoperative thyroglobulin levels of 13.15 ng/mL, 30.05 ng/mL, and 62.9 ng/mL were associated with the presence of ipsilateral lateral LNM, contralateral lateral LNM, and distant metastasis, respectively. Our results suggest that preoperative measurement of serum thyroglobulin may help to predict LNM and help to tailor surgery.

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The Relationship Between the BRAFV600E Mutation in Differentiated Thyroid Cancer and Clinicopathologic Factors in Vietnam

Biomedical Journal of Scientific & Technical Research ◽

10.26717/bjstr.2018.09.001748 ◽

2018 ◽

Vol 9 (1) ◽

Author(s):

Pham Cam Phuong

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Brafv600e Mutation ◽

Clinicopathologic Factors ◽

The Relationship

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Preoperative thyroid stimulating hormone level as risk factor for differentiated thyroid cancer

International Surgery Journal ◽

10.18203/2349-2902.isj20191252 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1063

Author(s):

Asem Fayed Moustafa ◽

Mohammed Sabery Ammar ◽

Asmaa El-Hantour ◽

Ahmed Farag El-Kased

Keyword(s):

Thyroid Cancer ◽

Papillary Carcinoma ◽

Multinodular Goiter ◽

Differentiated Thyroid Cancer ◽

Follicular Carcinoma ◽

Thyroid Stimulating Hormone ◽

Group I ◽

Female Predominance ◽

Group Ii ◽

The Relationship

Background: The objective of the study was to explore the relationship between TSH and differentiated thyroid cancer.Methods: From September 2017-September 2018, two groups included 247 euthyroid patients with thyroid swelling who had thyroidectomy studied retrospectively and prospectively by observing preoperative TSH level. Euthyroid adult patients with differentiated thyroid cancer and benign thyroid conditions and euthyroid patients with any thyroid diseases who will going to have thyroidectomy were included otherwise other thyroid conditions were excluded. Patients were classified into 192 retrospective cases (Group I) and 55 prospective cases (Group II).Results: Increased age of malignant cases with a female predominance. All cases presented with a neck swelling. Clinically in group I nodular swelling in 156 cases (81.2%), diffuse swelling in 36 cases (18.8%) and in group II, nodular swelling in 47 cases (85.5%) and diffuse swelling in 8 cases (14.5%). Histopathology of group I thyroid adenoma in 5 cases (4.8%) and multinodular goiter in 100 cases (95.2%). In addition 80 cases (92%) were papillary carcinoma and follicular carcinoma in 7 cases (8%) while in group II; multinodular goiter in29 cases (100%) and papillary carcinoma in 21 cases (80.8%) as well as follicular carcinoma in 5 cases (19.2%) in malignant cases. Group I showed a significant increase in TSH in malignant cases with the same finding in group II.Conclusions: TSH is an indicator for thyroid malignancy and FNAC biopsy is recommended for thyroid swellings showed elevated TSH.

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Usefulness of the Trh Test in the Management of Patients with Differentiated Thyroid Cancer

Tumori Journal ◽

10.1177/030089168607200610 ◽

1986 ◽

Vol 72 (6) ◽

pp. 597-600 ◽

Cited By ~ 1

Author(s):

Antonio Castagnoli ◽

M. Teresa Rosaria De Cristofaro ◽

Ivano Taddei ◽

Silvana Forni ◽

Cosimo Roberto Russo ◽

...

Keyword(s):

Thyroid Cancer ◽

Thyroid Hormones ◽

Differentiated Thyroid Cancer ◽

Suppressive Therapy ◽

Trh Test ◽

Trh Stimulation ◽

Serum Tsh

Thirty patients thyroidectomized for differentiated thyroid cancer were studied. Serum TSH was assayed in basal conditions and after TRH stimulation, while patients were in suppressive therapy with thyroid hormones. The basal TSH was normal in all the patients and less than 2 μ/ml in 20 patients. The TRH test was negative (no TSH response) in 27 patients and in all the cases with the basal TSH lower than 2 μU/ml.

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