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Association between preoperative thyrotrophin and clinicopathological and aggressive features of papillary thyroid cancer

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Abstract

Purpose

We aimed to investigate the relation between preoperative serum thyrotrophin (TSH) and clinicopathological features in patients with papillary thyroid carcinoma (PTC) and microcarcinoma (PTMC).

Methods

Patients who underwent thyroidectomy and diagnosed to have benign nodular disease or PTC/PTMC in our clinic were evaluated retrospectively. Patients with a previous history of thyroid surgery, patients using antithyroid medications or thyroid hormone and patients with tumors known to be unresponsive to TSH were excluded.

Results

Data of 1632 patients were analyzed. Histopathological diagnosis was benign in 969 (59.4%) and malignant in 663 (40.6%) patients. Preoperative median serum TSH was significantly higher in malignant compared to benign group (1.41 IU/dL vs. 0.98 IU/dL, p < 0.001). Malignancy risk increased gradually as going from hyperthyroidism to euthyroidism and hypothyroidism (20, 40.6, and 59.1%, respectively, p < 0.05). Serum TSH was lowest in benign nodular disease, higher in PTMC and highest in PTC (p < 0.001). This was also true when patients with positive antithyroid peroxidase/antithyroglobulin and with lymphocytic thyroiditis were excluded from the analysis (p < 0.001). Serum TSH was higher in patients with bilateral tumor, capsular invasion and lymph node metastasis (LNM) compared to patients with unilateral tumor, without capsule invasion and without LNM, respectively (p = 0.036, p = 0.002, and p = 0.001, respectively). Patients with aggressive variant PTC had higher serum TSH than nonaggressive ones (p < 0.05).

Conclusion

Preoperative serum TSH is associated with PTMC, PTC and LNM. Serum TSH seems to be related with thyroid cancer regardless of autoimmunity. With the present study, for the first time, we showed an association between serum TSH and aggressive variants of PTC.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey

    Abbas Ali Tam, Didem Ozdemir, Cevdet Aydın, Nagihan Bestepe, Reyhan Ersoy & Bekir Cakir

  2. Department of Surgery, Ataturk Training and Research Hospital, Ankara, Turkey

    Serap Ulusoy

  3. Department of Pathology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey

    Nuran Sungu

Authors
  1. Abbas Ali Tam
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  2. Didem Ozdemir
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Correspondence to Abbas Ali Tam.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Tam, A.A., Ozdemir, D., Aydın, C. et al. Association between preoperative thyrotrophin and clinicopathological and aggressive features of papillary thyroid cancer. Endocrine 59, 565–572 (2018). https://doi.org/10.1007/s12020-018-1523-6

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  • DOI: https://doi.org/10.1007/s12020-018-1523-6

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