open access

Vol 66, No 6 (2015)
Original papers
Published online: 2015-12-07
Submitted: 2014-12-07
Accepted: 2015-01-14
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TSH levels are associated with increased risk of thyroid carcinoma in patients with nodular disease

Tayane Muniz Fighera, Camila Luhm Silva Perez, Nadia Faris, Patricia Cristina Scarabotto, Thamires Tixiliski Silva, Teresa Cristina Santos Cavalcanti, Cleo Otaviano Mesa Junior, Fabiola Miasaki, Gilberto Jorge Paz Filho, Gisah Amaral Carvalho
DOI: 10.5603/EP.a2015.0059
·
Endokrynologia Polska 2015;66(6):480-485.

open access

Vol 66, No 6 (2015)
Original papers
Published online: 2015-12-07
Submitted: 2014-12-07
Accepted: 2015-01-14

Abstract

Introduction: Several studies have shown an increased risk of thyroid malignancies in patients with elevated TSH levels, even if these levels fell within the normal range. The aim of this study was to evaluate the relationship between TSH and risk of malignancy in patients with thyroid nodules.

Material and methods: We included 622 patients with thyroid nodules evaluated by fine needle aspiration and/or thyroidectomy and diagnosed by cytology or histology. Clinical and laboratory data, such as gender, weight, ultrasound findings, serum TSH, and free T4, were obtained from medical records or collected during each patient's first visit to our centre, prior to any intervention.

Results: Thyroid cancer was more prevalent in males (p = 0.012) and in patients with a solitary nodule (p < 0.01). Malignant tumours were predominantly solid, whereas benign tumours were solid or mixed (p = 0.053). The carcinoma risk in patients with thyroid nodules increased with increasing serum TSH concentration, with a significant elevation in patients with serum TSH levels above 1.64 mU/L (p < 0.001). This relationship persisted even when the subgroup of patients undergoing thyroidectomy was analysed separately. Patients with follicular lesions presented with significantly higher TSH levels compared to patients with benign cytology (p < 0.001). We also found correlation between elevated TSH and tumour size (p = 0.005).

Conclusions: Our results suggest that in patients with nodular thyroid disease the carcinoma risk rose in parallel with serum TSH concentration, with significant increases evident in patients with serum TSH greater than 1.64 mU/L. (Endokrynol Pol 2015; 66 (6): 480–485)

Abstract

Introduction: Several studies have shown an increased risk of thyroid malignancies in patients with elevated TSH levels, even if these levels fell within the normal range. The aim of this study was to evaluate the relationship between TSH and risk of malignancy in patients with thyroid nodules.

Material and methods: We included 622 patients with thyroid nodules evaluated by fine needle aspiration and/or thyroidectomy and diagnosed by cytology or histology. Clinical and laboratory data, such as gender, weight, ultrasound findings, serum TSH, and free T4, were obtained from medical records or collected during each patient's first visit to our centre, prior to any intervention.

Results: Thyroid cancer was more prevalent in males (p = 0.012) and in patients with a solitary nodule (p < 0.01). Malignant tumours were predominantly solid, whereas benign tumours were solid or mixed (p = 0.053). The carcinoma risk in patients with thyroid nodules increased with increasing serum TSH concentration, with a significant elevation in patients with serum TSH levels above 1.64 mU/L (p < 0.001). This relationship persisted even when the subgroup of patients undergoing thyroidectomy was analysed separately. Patients with follicular lesions presented with significantly higher TSH levels compared to patients with benign cytology (p < 0.001). We also found correlation between elevated TSH and tumour size (p = 0.005).

Conclusions: Our results suggest that in patients with nodular thyroid disease the carcinoma risk rose in parallel with serum TSH concentration, with significant increases evident in patients with serum TSH greater than 1.64 mU/L. (Endokrynol Pol 2015; 66 (6): 480–485)

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Keywords

TSH; malignancy; thyroid nodules

About this article
Title

TSH levels are associated with increased risk of thyroid carcinoma in patients with nodular disease

Journal

Endokrynologia Polska

Issue

Vol 66, No 6 (2015)

Pages

480-485

Published online

2015-12-07

DOI

10.5603/EP.a2015.0059

Bibliographic record

Endokrynologia Polska 2015;66(6):480-485.

Keywords

TSH
malignancy
thyroid nodules

Authors

Tayane Muniz Fighera
Camila Luhm Silva Perez
Nadia Faris
Patricia Cristina Scarabotto
Thamires Tixiliski Silva
Teresa Cristina Santos Cavalcanti
Cleo Otaviano Mesa Junior
Fabiola Miasaki
Gilberto Jorge Paz Filho
Gisah Amaral Carvalho

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