The utility of preoperative serum thyroid-stimulating hormone level for predicting malignant nodular thyroid disease.

Abstract

INTRODUCTION:

The aim of this study was to assess whether serum thyroid-stimulating hormone (TSH) levels are of value in predicting malignancy in patients with nodular thyroid disease (NTD).

METHODS:

Patients with NTD and a preoperative TSH level who underwent thyroidectomy between 1990 and 2008 were identified from a prospective database. Age, sex, TSH concentration, nodule size, and pathology were evaluated. Logistic regression analysis was used to determine which factors were predictive of malignancy.

RESULTS:

Six hundred fifty-three patients were analyzed. The overall rate of malignancy was 20%; the rate was highest in patients<30 years (32%). The mean TSH level was higher in the malignant group (5.5 microIU/mL vs 1.4 microIU/mL, P<.0001). The rate of malignancy was 65% in patients with TSH levels>5.5 microIU/mL. Logistic regression analysis revealed that TSH level was the only significant risk factor for malignancy.

CONCLUSION:

The serum TSH level may be useful in predicting the probability of cancer and optimizing the extent of thyroidectomy in patients with NTD.

• Authors: Judy Jin, Rhoderick Machekano, Christopher R McHenry
• Journal: American journal of surgery (Am J Surg) Vol. 199 Issue 3 Pg. 294-7; discussion 298 (Mar 2010) ISSN: 1879-1883 [Electronic] United States
• PMID: 20226898 (Publication Type: Journal Article)
• Copyright: Copyright (c) 2010 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Thyrotropin

Topics

• Adult
• Aged
• Biomarkers (blood)
• Diagnosis, Differential
• Humans
• Male
• Middle Aged
• Predictive Value of Tests
• Preoperative Care
• Retrospective Studies
• Thyroid Neoplasms (blood, diagnosis, surgery)
• Thyroid Nodule (blood, diagnosis, surgery)
• Thyrotropin (blood)