Could Serum TSH Levels Predict Malignancy in Euthyroid Patients Affected by Thyroid Nodules with Indeterminate Cytology?


Journal

International journal of endocrinology
ISSN: 1687-8337
Titre abrégé: Int J Endocrinol
Pays: Egypt
ID NLM: 101516376

Informations de publication

Date de publication:
2020
Historique:
received: 27 05 2019
revised: 09 09 2019
accepted: 30 03 2020
entrez: 8 5 2020
pubmed: 8 5 2020
medline: 8 5 2020
Statut: epublish

Résumé

Serum TSH levels in the upper-normal range were reported to be associated with increased risk of thyroid malignancy. However, measurement of TSH levels is currently not recommended for assessing the risk of malignancy in patients with newly diagnosed thyroid nodules. To evaluate a possible relationship between the serum levels of TSH and the histological outcome of patients undergoing thyroidectomy for thyroid nodules with indeterminate cytology. We collected the clinical data of all patients who had performed ultrasound-guided FNA of thyroid nodules with cytological diagnosis of indeterminate lesions (TIR3A and TIR3B) and serum TSH levels within the normal range. All patients had been submitted to thyroid surgery (hemi or thyroidectomy, as appropriate), and histological diagnosis had been performed. A histological diagnosis of thyroid malignancy was rendered in 74/378 (19.6%) nodules. Patients with histologically proven thyroid malignancy were characterized by higher serum levels of TSH as compared to patients with histologically proven benign nodules (3.03 ± 1.16 vs. 2.37 ± 1.19 mIU/L, TSH levels in the upper-normal range are associated with an increased risk of thyroid malignancy in patients affected by thyroid nodules with indeterminate cytology at FNA. The measurement of serum TSH levels represents an easily performed additional tool for decision-making in patients with indeterminate cytological findings.

Sections du résumé

BACKGROUND BACKGROUND
Serum TSH levels in the upper-normal range were reported to be associated with increased risk of thyroid malignancy. However, measurement of TSH levels is currently not recommended for assessing the risk of malignancy in patients with newly diagnosed thyroid nodules.
OBJECTIVE OBJECTIVE
To evaluate a possible relationship between the serum levels of TSH and the histological outcome of patients undergoing thyroidectomy for thyroid nodules with indeterminate cytology.
MATERIALS AND METHODS METHODS
We collected the clinical data of all patients who had performed ultrasound-guided FNA of thyroid nodules with cytological diagnosis of indeterminate lesions (TIR3A and TIR3B) and serum TSH levels within the normal range. All patients had been submitted to thyroid surgery (hemi or thyroidectomy, as appropriate), and histological diagnosis had been performed.
RESULTS RESULTS
A histological diagnosis of thyroid malignancy was rendered in 74/378 (19.6%) nodules. Patients with histologically proven thyroid malignancy were characterized by higher serum levels of TSH as compared to patients with histologically proven benign nodules (3.03 ± 1.16 vs. 2.37 ± 1.19 mIU/L,
CONCLUSIONS CONCLUSIONS
TSH levels in the upper-normal range are associated with an increased risk of thyroid malignancy in patients affected by thyroid nodules with indeterminate cytology at FNA. The measurement of serum TSH levels represents an easily performed additional tool for decision-making in patients with indeterminate cytological findings.

Identifiants

pubmed: 32377187
doi: 10.1155/2020/7543930
pmc: PMC7191401
doi:

Types de publication

Journal Article

Langues

eng

Pagination

7543930

Informations de copyright

Copyright © 2020 Carlo Cappelli et al.

Déclaration de conflit d'intérêts

The authors declare that there are no conflicts of interest regarding the publication of this paper.

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Auteurs

Carlo Cappelli (C)

Department of Clinical and Experimental Sciences, SSD Medicina ad Indirizzo Endocrino-metabolico, University of Brescia, ASST Spedali Civili di Brescia, 25123 Brescia, Italy.

Ilenia Pirola (I)

Department of Clinical and Experimental Sciences, SSD Medicina ad Indirizzo Endocrino-metabolico, University of Brescia, ASST Spedali Civili di Brescia, 25123 Brescia, Italy.

Elena Gandossi (E)

Department of Clinical and Experimental Sciences, SSD Medicina ad Indirizzo Endocrino-metabolico, University of Brescia, ASST Spedali Civili di Brescia, 25123 Brescia, Italy.

Mario Rotondi (M)

Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Laboratory for Endocrine Disruptors, University of Pavia, Pavia, Italy.

Davide Lombardi (D)

Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.

Claudio Casella (C)

Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.

Fiorella Marini (F)

Department of Clinical and Experimental Sciences, SSD Medicina ad Indirizzo Endocrino-metabolico, University of Brescia, ASST Spedali Civili di Brescia, 25123 Brescia, Italy.

Maura Saullo (M)

Department of Clinical and Experimental Sciences, SSD Medicina ad Indirizzo Endocrino-metabolico, University of Brescia, ASST Spedali Civili di Brescia, 25123 Brescia, Italy.

Barbara Agosti (B)

Department of Clinical and Experimental Sciences, SSD Medicina ad Indirizzo Endocrino-metabolico, University of Brescia, ASST Spedali Civili di Brescia, 25123 Brescia, Italy.

Elena Di Lodovico (E)

Department of Clinical and Experimental Sciences, SSD Medicina ad Indirizzo Endocrino-metabolico, University of Brescia, ASST Spedali Civili di Brescia, 25123 Brescia, Italy.

Luca Chiovato (L)

Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Laboratory for Endocrine Disruptors, University of Pavia, Pavia, Italy.

Alberto Ferlin (A)

Department of Clinical and Experimental Sciences, SSD Medicina ad Indirizzo Endocrino-metabolico, University of Brescia, ASST Spedali Civili di Brescia, 25123 Brescia, Italy.

Maurizio Castellano (M)

Department of Clinical and Experimental Sciences, SSD Medicina ad Indirizzo Endocrino-metabolico, University of Brescia, ASST Spedali Civili di Brescia, 25123 Brescia, Italy.

Classifications MeSH