Anping Su1, Wanjun Zhao2, Wenshuang Wu3, Tao Wei4, Meifang Ruan5, Zhihui Li6, Jingqiang Zhu7. 1. Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: suanpingping@126.com. 2. Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: 594171168@qq.com. 3. Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: wenshuang_wu@163.com. 4. Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: surgeonwei@163.com. 5. Department of Medical Affairs, Merck Serono Co., Ltd, Beijing, China. Electronic address: meifang.ruan@merckgroup.com. 6. Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: rockoliver@sina.com. 7. Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: 17643571@qq.com.
Abstract
BACKGROUND: This systematic review and meta-analysis was conducted to determine the value of preoperative thyroid-stimulating hormone (TSH) levels in assessing the risk of differentiated thyroid cancer (DTC) in patients with thyroid nodules. METHODS: This meta-analysis included 23,799 subjects (15,406 non-Chinese and 8,393 Chinese) with thyroid nodules. Multivariate and individual adjusted odds ratios (OR) were calculated for a 1 mU/L increase in preoperative TSH levels to determine the risk of malignant DTC. RESULTS: The OR for DTC in relation to preoperative TSH levels was significant in Chinese (1.25 [1.11, 1.40], Z = 3.67, p = 0.0002) and non-Chinese subjects (1.12 [1.03, 1.22], Z = 2.72, p = 0.006). The overall random-effects model indicated that there was a significantly increased risk for DTC in patients with thyroid nodules (OR 1.16 [1.06, 1.27], Z = 3.29, p = 0.007). CONCLUSIONS: A significant association between higher TSH levels and risk of DTC was observed in both population groups investigated, with higher ORs for Chinese subjects.
BACKGROUND: This systematic review and meta-analysis was conducted to determine the value of preoperative thyroid-stimulating hormone (TSH) levels in assessing the risk of differentiated thyroid cancer (DTC) in patients with thyroid nodules. METHODS: This meta-analysis included 23,799 subjects (15,406 non-Chinese and 8,393 Chinese) with thyroid nodules. Multivariate and individual adjusted odds ratios (OR) were calculated for a 1 mU/L increase in preoperative TSH levels to determine the risk of malignant DTC. RESULTS: The OR for DTC in relation to preoperative TSH levels was significant in Chinese (1.25 [1.11, 1.40], Z = 3.67, p = 0.0002) and non-Chinese subjects (1.12 [1.03, 1.22], Z = 2.72, p = 0.006). The overall random-effects model indicated that there was a significantly increased risk for DTC in patients with thyroid nodules (OR 1.16 [1.06, 1.27], Z = 3.29, p = 0.007). CONCLUSIONS: A significant association between higher TSH levels and risk of DTC was observed in both population groups investigated, with higher ORs for Chinese subjects.