CONTEXT: TSH is a known thyroid growth factor, but the pathogenic role of TSH in thyroid oncogenesis is unclear. OBJECTIVE: The aim was to examine the relationship between preoperative TSH and differentiated thyroid cancer (DTC). DESIGN: The design was a retrospective cohort. SETTING, PARTICIPANTS: Between May 1994 and January 2007, 1198 patients underwent thyroid surgery at a single hospital. Data from the 843 patients with preoperative serum TSH concentration were recorded. MAIN OUTCOME MEASURES: Serum TSH concentration was measured with a sensitive assay. Diagnoses of DTC vs. benign thyroid disease were based on surgical pathology reports. RESULTS: Twenty-nine percent of patients (241 of 843) had DTC on final pathology. On both univariate and multivariable analyses, risk of malignancy correlated with higher TSH level (P=0.007). The likelihood of malignancy was 16% (nine of 55) when TSH was less than 0.06 mIU/liter vs. 52% (15 of 29) when 5.00 mIU/liter or greater (P=0.001). When TSH was between 0.40 and 1.39 mIU/liter, the likelihood of malignancy was 25% (85 of 347) vs. 35% (109 of 308) when TSH was between 1.40 and 4.99 mIU/liter (P=0.002). The mean TSH was 4.9+/-1.5 mIU/liter in patients with stage III/IV disease vs. 2.1+/-0.2 mIU/liter in patients with stage I/II disease (P=0.002). CONCLUSIONS: The likelihood of thyroid cancer increases with higher serum TSH concentration. Even within normal TSH ranges, a TSH level above the population mean is associated with significantly greater likelihood of thyroid cancer than a TSH below the mean. Shown for the first time, higher TSH level is associated with advanced stage DTC.
CONTEXT: TSH is a known thyroid growth factor, but the pathogenic role of TSH in thyroid oncogenesis is unclear. OBJECTIVE: The aim was to examine the relationship between preoperative TSH and differentiated thyroid cancer (DTC). DESIGN: The design was a retrospective cohort. SETTING, PARTICIPANTS: Between May 1994 and January 2007, 1198 patients underwent thyroid surgery at a single hospital. Data from the 843 patients with preoperative serum TSH concentration were recorded. MAIN OUTCOME MEASURES: Serum TSH concentration was measured with a sensitive assay. Diagnoses of DTC vs. benign thyroid disease were based on surgical pathology reports. RESULTS: Twenty-nine percent of patients (241 of 843) had DTC on final pathology. On both univariate and multivariable analyses, risk of malignancy correlated with higher TSH level (P=0.007). The likelihood of malignancy was 16% (nine of 55) when TSH was less than 0.06 mIU/liter vs. 52% (15 of 29) when 5.00 mIU/liter or greater (P=0.001). When TSH was between 0.40 and 1.39 mIU/liter, the likelihood of malignancy was 25% (85 of 347) vs. 35% (109 of 308) when TSH was between 1.40 and 4.99 mIU/liter (P=0.002). The mean TSH was 4.9+/-1.5 mIU/liter in patients with stage III/IV disease vs. 2.1+/-0.2 mIU/liter in patients with stage I/II disease (P=0.002). CONCLUSIONS: The likelihood of thyroid cancer increases with higher serum TSH concentration. Even within normal TSH ranges, a TSH level above the population mean is associated with significantly greater likelihood of thyroid cancer than a TSH below the mean. Shown for the first time, higher TSH level is associated with advanced stage DTC.
Authors: Joseph G Hollowell; Norman W Staehling; W Dana Flanders; W Harry Hannon; Elaine W Gunter; Carole A Spencer; Lewis E Braverman Journal: J Clin Endocrinol Metab Date: 2002-02 Impact factor: 5.958
Authors: Francesco Vermiglio; Vincenzo Pio Lo Presti; Maria Antonia Violi; Mariacarla Moleti; Maria Grazia Castagna; Maria Daniela Finocchiaro; Filiberto Mattina; Mattia Mandolfino; Giovanni Zimbaro; Francesco Trimarchi Journal: Clin Endocrinol (Oxf) Date: 2003-09 Impact factor: 3.478
Authors: I B Hales; A McElduff; P Crummer; P Clifton-Bligh; L Delbridge; R Hoschl; A Poole; T S Reeve; E Wilmshurst; J Wiseman Journal: J Clin Endocrinol Metab Date: 1992-09 Impact factor: 5.958
Authors: Rachael A Callcut; Suzanne M Selvaggi; Eberhard Mack; Omer Ozgul; Thomas Warner; Herbert Chen Journal: Ann Surg Oncol Date: 2004-01 Impact factor: 5.344
Authors: M Regina Castro; Rachel P Espiritu; Rebecca S Bahn; Michael R Henry; Hossein Gharib; Pedro J Caraballo; John C Morris Journal: Thyroid Date: 2011-10-18 Impact factor: 6.568
Authors: Li Xu; Matthias Port; Stefano Landi; Federica Gemignani; Monica Cipollini; Rossella Elisei; Lilia Goudeva; Jörg Andreas Müller; Kai Nerlich; Giovanni Pellegrini; Christoph Reiners; Cristina Romei; Robert Schwab; Michael Abend; Erich M Sturgis Journal: Thyroid Date: 2014-05-05 Impact factor: 6.568