Serum TSH levels as a predictor of malignancy in thyroid nodules: A prospective study
The role of serum TSH concentrations as a predictor of malignancy of thyroid nodule remains unclear. To prospectively evaluate the usefulness of serum TSH levels as a predictor of malignancy in thyroid nodules. Patients with thyroid nodule(s) who underwent fine-needle aspiration biopsy under ultraso...
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| description | The role of serum TSH concentrations as a predictor of malignancy of thyroid nodule remains unclear.
To prospectively evaluate the usefulness of serum TSH levels as a predictor of malignancy in thyroid nodules.
Patients with thyroid nodule(s) who underwent fine-needle aspiration biopsy under ultrasonographic guidance in a tertiary, university-based hospital were consecutively evaluated. Patients with known thyroid cancer and/or patients receiving thyroid medication were excluded. Serum TSH levels were measured by two differents methodologies, chemiluminescent (CLIA) and electrochemiluminscent immunoassay (ECLIA). Anatomopathological exam of tissue samples obtained at thyroidectomy was considered the gold standard for the diagnosis of thyroid cancer.
A total of 615 patients participated in the study. The mean age was 55.9±14.7 years, and 544(88.5%) were female. The median TSH values were 1.48 and 1.55 μU/mL, using CLIA and ECLIA, respectively. One-hundred-sixty patients underwent thyroidectomy and the final diagnoses were malignant in 47(29.4%) patients. TSH levels were higher in patients with malignant than in those with benign nodules in both TSH assays: 2.25 vs. 1.50; P = 0.04 (CLIA) and 2.33 vs. 1.27; P = 0.03 (ECLIA). Further analysis using binary logistic regression identified elevated TSH levels, a family history of thyroid cancer, the presence of microcalcifications, and solitary nodule on US as independent risk factors for malignancy in patients with thyroid nodules. Additional analyses using TSH levels as a categorical variable, defined by ROC curve analysis, showed that the risk of malignancy was approximately 3-fold higher in patients with TSH levels ≥2.26 μU/mL than in patients with lower TSH levels (P = 0.00).
Higher serum TSH levels are associated with an increased risk of thyroid cancer in patients with thyroid nodules. Using TSH levels as an adjunctive diagnostic test for stratifying the risk of malignancy associated with a thyroid nodule may help on defining the best therapeutic approaches. |
| doi_str_mv | 10.1371/journal.pone.0188123 |
| format | Article |
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To prospectively evaluate the usefulness of serum TSH levels as a predictor of malignancy in thyroid nodules.
Patients with thyroid nodule(s) who underwent fine-needle aspiration biopsy under ultrasonographic guidance in a tertiary, university-based hospital were consecutively evaluated. Patients with known thyroid cancer and/or patients receiving thyroid medication were excluded. Serum TSH levels were measured by two differents methodologies, chemiluminescent (CLIA) and electrochemiluminscent immunoassay (ECLIA). Anatomopathological exam of tissue samples obtained at thyroidectomy was considered the gold standard for the diagnosis of thyroid cancer.
A total of 615 patients participated in the study. The mean age was 55.9±14.7 years, and 544(88.5%) were female. The median TSH values were 1.48 and 1.55 μU/mL, using CLIA and ECLIA, respectively. One-hundred-sixty patients underwent thyroidectomy and the final diagnoses were malignant in 47(29.4%) patients. TSH levels were higher in patients with malignant than in those with benign nodules in both TSH assays: 2.25 vs. 1.50; P = 0.04 (CLIA) and 2.33 vs. 1.27; P = 0.03 (ECLIA). Further analysis using binary logistic regression identified elevated TSH levels, a family history of thyroid cancer, the presence of microcalcifications, and solitary nodule on US as independent risk factors for malignancy in patients with thyroid nodules. Additional analyses using TSH levels as a categorical variable, defined by ROC curve analysis, showed that the risk of malignancy was approximately 3-fold higher in patients with TSH levels ≥2.26 μU/mL than in patients with lower TSH levels (P = 0.00).
Higher serum TSH levels are associated with an increased risk of thyroid cancer in patients with thyroid nodules. Using TSH levels as an adjunctive diagnostic test for stratifying the risk of malignancy associated with a thyroid nodule may help on defining the best therapeutic approaches.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0188123</identifier><identifier>PMID: 29145466</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Analysis ; Biology and Life Sciences ; Biomarkers, Tumor - blood ; Biopsy ; Cancer ; Cellular biology ; Chemiluminescence ; Diagnosis ; Diagnostic systems ; Drugs ; Female ; Gene expression ; Genetics ; Health aspects ; Health risks ; Humans ; Immunoassay ; Internet ; Iodine ; Male ; Malignancy ; Medical diagnosis ; Medical research ; Medicine and Health Sciences ; Middle Aged ; Mutation ; Nodules ; Patients ; Physical Sciences ; Prospective Studies ; Regression analysis ; Research and Analysis Methods ; Risk analysis ; Risk factors ; Studies ; Thyroid ; Thyroid cancer ; Thyroid Neoplasms - blood ; Thyroid Neoplasms - diagnosis ; Thyroid-stimulating hormone ; Thyroidectomy ; Thyrotropin - blood ; Ultrasonic imaging</subject><ispartof>PloS one, 2017-11, Vol.12 (11), p.e0188123-e0188123</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Golbert et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Golbert et al 2017 Golbert et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-b27ab00c069deb8d15ed58f62157e9d2a84d822c1508cac27c4905a0d5ac26a63</citedby><cites>FETCH-LOGICAL-c758t-b27ab00c069deb8d15ed58f62157e9d2a84d822c1508cac27c4905a0d5ac26a63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690674/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690674/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29145466$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Vicha, Ales</contributor><creatorcontrib>Golbert, Lenara</creatorcontrib><creatorcontrib>de Cristo, Ana Patrícia</creatorcontrib><creatorcontrib>Faccin, Carlo Sasso</creatorcontrib><creatorcontrib>Farenzena, Mauricio</creatorcontrib><creatorcontrib>Folgierini, Heloísa</creatorcontrib><creatorcontrib>Graudenz, Marcia Silveira</creatorcontrib><creatorcontrib>Maia, Ana Luiza</creatorcontrib><title>Serum TSH levels as a predictor of malignancy in thyroid nodules: A prospective study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The role of serum TSH concentrations as a predictor of malignancy of thyroid nodule remains unclear.
To prospectively evaluate the usefulness of serum TSH levels as a predictor of malignancy in thyroid nodules.
Patients with thyroid nodule(s) who underwent fine-needle aspiration biopsy under ultrasonographic guidance in a tertiary, university-based hospital were consecutively evaluated. Patients with known thyroid cancer and/or patients receiving thyroid medication were excluded. Serum TSH levels were measured by two differents methodologies, chemiluminescent (CLIA) and electrochemiluminscent immunoassay (ECLIA). Anatomopathological exam of tissue samples obtained at thyroidectomy was considered the gold standard for the diagnosis of thyroid cancer.
A total of 615 patients participated in the study. The mean age was 55.9±14.7 years, and 544(88.5%) were female. The median TSH values were 1.48 and 1.55 μU/mL, using CLIA and ECLIA, respectively. One-hundred-sixty patients underwent thyroidectomy and the final diagnoses were malignant in 47(29.4%) patients. TSH levels were higher in patients with malignant than in those with benign nodules in both TSH assays: 2.25 vs. 1.50; P = 0.04 (CLIA) and 2.33 vs. 1.27; P = 0.03 (ECLIA). Further analysis using binary logistic regression identified elevated TSH levels, a family history of thyroid cancer, the presence of microcalcifications, and solitary nodule on US as independent risk factors for malignancy in patients with thyroid nodules. Additional analyses using TSH levels as a categorical variable, defined by ROC curve analysis, showed that the risk of malignancy was approximately 3-fold higher in patients with TSH levels ≥2.26 μU/mL than in patients with lower TSH levels (P = 0.00).
Higher serum TSH levels are associated with an increased risk of thyroid cancer in patients with thyroid nodules. Using TSH levels as an adjunctive diagnostic test for stratifying the risk of malignancy associated with a thyroid nodule may help on defining the best therapeutic approaches.</description><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Biomarkers, Tumor - blood</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Cellular biology</subject><subject>Chemiluminescence</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Drugs</subject><subject>Female</subject><subject>Gene expression</subject><subject>Genetics</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Humans</subject><subject>Immunoassay</subject><subject>Internet</subject><subject>Iodine</subject><subject>Male</subject><subject>Malignancy</subject><subject>Medical diagnosis</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Nodules</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Research and Analysis Methods</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Studies</subject><subject>Thyroid</subject><subject>Thyroid cancer</subject><subject>Thyroid Neoplasms - blood</subject><subject>Thyroid Neoplasms - diagnosis</subject><subject>Thyroid-stimulating hormone</subject><subject>Thyroidectomy</subject><subject>Thyrotropin - blood</subject><subject>Ultrasonic imaging</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl1r2zAUhs3YWLtu_2BshsHYLpJJsiXLuxiUsq2BQmFpdytk6ThRUKxUksPy76c0bolHL4YE-nrOK52jN8veYjTFRYW_rFzvO2mnG9fBFGHOMSmeZae4LsiEEVQ8P5qfZK9CWCFEC87Yy-yE1LikJWOn2e0cfL_Ob-aXuYUt2JDL1PONB21UdD53bb6W1iw62aldbro8LnfeGZ13TvcWwtf8PNEubEBFs4U8xF7vXmcvWmkDvBnGs-z2x_ebi8vJ1fXP2cX51URVlMdJQyrZIKQQqzU0XGMKmvKWEUwrqDWRvNScEIUp4koqUqmyRlQiTdOCSVacZe8PuhvrghgqEgSuGcWMFyVPxOxAaCdXYuPNWvqdcNKI-w3nF0L6aJQFIStoEeOkopqVFW0aRGkJFa0UaRRCTdL6NtzWN2vQCrropR2Jjk86sxQLtxWU1YhVZRL4NAh4d9dDiGJtggJrZQeuv383IwVFeJ_Zh3_Qp7MbqIVMCZiudeletRcV5xSXjNcl2VPTJ6jUNKyNSvZpTdofBXweBSQmwp-4kH0IYjb_9f_s9e8x-_GIXYK0cRmc7aNxXRiD5QFUyVnBQ_tYZIzE3v0P1RB794vB_Sns3fEHPQY92L34C-8J_n0</recordid><startdate>20171116</startdate><enddate>20171116</enddate><creator>Golbert, Lenara</creator><creator>de Cristo, Ana Patrícia</creator><creator>Faccin, Carlo Sasso</creator><creator>Farenzena, Mauricio</creator><creator>Folgierini, Heloísa</creator><creator>Graudenz, Marcia Silveira</creator><creator>Maia, Ana Luiza</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20171116</creationdate><title>Serum TSH levels as a predictor of malignancy in thyroid nodules: A prospective study</title><author>Golbert, Lenara ; de Cristo, Ana Patrícia ; Faccin, Carlo Sasso ; Farenzena, Mauricio ; Folgierini, Heloísa ; Graudenz, Marcia Silveira ; Maia, Ana Luiza</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-b27ab00c069deb8d15ed58f62157e9d2a84d822c1508cac27c4905a0d5ac26a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Biomarkers, Tumor - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Golbert, Lenara</au><au>de Cristo, Ana Patrícia</au><au>Faccin, Carlo Sasso</au><au>Farenzena, Mauricio</au><au>Folgierini, Heloísa</au><au>Graudenz, Marcia Silveira</au><au>Maia, Ana Luiza</au><au>Vicha, Ales</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum TSH levels as a predictor of malignancy in thyroid nodules: A prospective study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-11-16</date><risdate>2017</risdate><volume>12</volume><issue>11</issue><spage>e0188123</spage><epage>e0188123</epage><pages>e0188123-e0188123</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The role of serum TSH concentrations as a predictor of malignancy of thyroid nodule remains unclear.
To prospectively evaluate the usefulness of serum TSH levels as a predictor of malignancy in thyroid nodules.
Patients with thyroid nodule(s) who underwent fine-needle aspiration biopsy under ultrasonographic guidance in a tertiary, university-based hospital were consecutively evaluated. Patients with known thyroid cancer and/or patients receiving thyroid medication were excluded. Serum TSH levels were measured by two differents methodologies, chemiluminescent (CLIA) and electrochemiluminscent immunoassay (ECLIA). Anatomopathological exam of tissue samples obtained at thyroidectomy was considered the gold standard for the diagnosis of thyroid cancer.
A total of 615 patients participated in the study. The mean age was 55.9±14.7 years, and 544(88.5%) were female. The median TSH values were 1.48 and 1.55 μU/mL, using CLIA and ECLIA, respectively. One-hundred-sixty patients underwent thyroidectomy and the final diagnoses were malignant in 47(29.4%) patients. TSH levels were higher in patients with malignant than in those with benign nodules in both TSH assays: 2.25 vs. 1.50; P = 0.04 (CLIA) and 2.33 vs. 1.27; P = 0.03 (ECLIA). Further analysis using binary logistic regression identified elevated TSH levels, a family history of thyroid cancer, the presence of microcalcifications, and solitary nodule on US as independent risk factors for malignancy in patients with thyroid nodules. Additional analyses using TSH levels as a categorical variable, defined by ROC curve analysis, showed that the risk of malignancy was approximately 3-fold higher in patients with TSH levels ≥2.26 μU/mL than in patients with lower TSH levels (P = 0.00).
Higher serum TSH levels are associated with an increased risk of thyroid cancer in patients with thyroid nodules. Using TSH levels as an adjunctive diagnostic test for stratifying the risk of malignancy associated with a thyroid nodule may help on defining the best therapeutic approaches.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29145466</pmid><doi>10.1371/journal.pone.0188123</doi><tpages>e0188123</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| recordid | cdi_plos_journals_1965168348 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Aged Analysis Biology and Life Sciences Biomarkers, Tumor - blood Biopsy Cancer Cellular biology Chemiluminescence Diagnosis Diagnostic systems Drugs Female Gene expression Genetics Health aspects Health risks Humans Immunoassay Internet Iodine Male Malignancy Medical diagnosis Medical research Medicine and Health Sciences Middle Aged Mutation Nodules Patients Physical Sciences Prospective Studies Regression analysis Research and Analysis Methods Risk analysis Risk factors Studies Thyroid Thyroid cancer Thyroid Neoplasms - blood Thyroid Neoplasms - diagnosis Thyroid-stimulating hormone Thyroidectomy Thyrotropin - blood Ultrasonic imaging |
| title | Serum TSH levels as a predictor of malignancy in thyroid nodules: A prospective study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T17%3A25%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Serum%20TSH%20levels%20as%20a%20predictor%20of%20malignancy%20in%20thyroid%20nodules:%20A%20prospective%20study&rft.jtitle=PloS%20one&rft.au=Golbert,%20Lenara&rft.date=2017-11-16&rft.volume=12&rft.issue=11&rft.spage=e0188123&rft.epage=e0188123&rft.pages=e0188123-e0188123&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0188123&rft_dat=%3Cgale_plos_%3EA514689428%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1965168348&rft_id=info:pmid/29145466&rft_galeid=A514689428&rft_doaj_id=oai_doaj_org_article_a7ef068275d6475bb0554e757c2bc00b&rfr_iscdi=true |