Serum TSH levels as a predictor of malignancy in thyroid nodules : a prospective study
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/184257 |
Resumo: | The role of serum TSH concentrations as a predictor of malignancy of thyroid nodule remains unclear. Objective To prospectively evaluate the usefulness of serum TSH levels as a predictor of malignancy in thyroid nodules. Methods 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. Results 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). Conclusions 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. |
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Golbert, LenaraCristo, Ana Patrícia deFaccin, Carlo SassoFarenzena, MauricioFolgierini, Heloisa JesseGraudenz, Márcia SilveiraMaia, Ana Luiza Silva2018-11-01T02:49:32Z20171932-6203http://hdl.handle.net/10183/184257001078602The role of serum TSH concentrations as a predictor of malignancy of thyroid nodule remains unclear. Objective To prospectively evaluate the usefulness of serum TSH levels as a predictor of malignancy in thyroid nodules. Methods 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. Results 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). Conclusions 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.application/pdfengPLoS ONE. San Francisco. Vol. 12, no.11 (Nov. 2017), e0188123, 12 p.Biomarcadores tumoraisTireotropinaEstudos prospectivosNeoplasias da glândula tireóideSerum TSH levels as a predictor of malignancy in thyroid nodules : a prospective studyEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001078602.pdf.txt001078602.pdf.txtExtracted Texttext/plain37805http://www.lume.ufrgs.br/bitstream/10183/184257/2/001078602.pdf.txtff93b10da7f498c9b6f678bbf1fde25fMD52ORIGINAL001078602.pdfTexto completo (inglês)application/pdf4044240http://www.lume.ufrgs.br/bitstream/10183/184257/1/001078602.pdf7fd8690334bca168249277fd407458f6MD5110183/1842572018-11-02 02:49:15.342022oai:www.lume.ufrgs.br:10183/184257Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2018-11-02T05:49:15Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Serum TSH levels as a predictor of malignancy in thyroid nodules : a prospective study |
title |
Serum TSH levels as a predictor of malignancy in thyroid nodules : a prospective study |
spellingShingle |
Serum TSH levels as a predictor of malignancy in thyroid nodules : a prospective study Golbert, Lenara Biomarcadores tumorais Tireotropina Estudos prospectivos Neoplasias da glândula tireóide |
title_short |
Serum TSH levels as a predictor of malignancy in thyroid nodules : a prospective study |
title_full |
Serum TSH levels as a predictor of malignancy in thyroid nodules : a prospective study |
title_fullStr |
Serum TSH levels as a predictor of malignancy in thyroid nodules : a prospective study |
title_full_unstemmed |
Serum TSH levels as a predictor of malignancy in thyroid nodules : a prospective study |
title_sort |
Serum TSH levels as a predictor of malignancy in thyroid nodules : a prospective study |
author |
Golbert, Lenara |
author_facet |
Golbert, Lenara Cristo, Ana Patrícia de Faccin, Carlo Sasso Farenzena, Mauricio Folgierini, Heloisa Jesse Graudenz, Márcia Silveira Maia, Ana Luiza Silva |
author_role |
author |
author2 |
Cristo, Ana Patrícia de Faccin, Carlo Sasso Farenzena, Mauricio Folgierini, Heloisa Jesse Graudenz, Márcia Silveira Maia, Ana Luiza Silva |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Golbert, Lenara Cristo, Ana Patrícia de Faccin, Carlo Sasso Farenzena, Mauricio Folgierini, Heloisa Jesse Graudenz, Márcia Silveira Maia, Ana Luiza Silva |
dc.subject.por.fl_str_mv |
Biomarcadores tumorais Tireotropina Estudos prospectivos Neoplasias da glândula tireóide |
topic |
Biomarcadores tumorais Tireotropina Estudos prospectivos Neoplasias da glândula tireóide |
description |
The role of serum TSH concentrations as a predictor of malignancy of thyroid nodule remains unclear. Objective To prospectively evaluate the usefulness of serum TSH levels as a predictor of malignancy in thyroid nodules. Methods 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. Results 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). Conclusions 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. |
publishDate |
2017 |
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2017 |
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2018-11-01T02:49:32Z |
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1932-6203 |
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PLoS ONE. San Francisco. Vol. 12, no.11 (Nov. 2017), e0188123, 12 p. |
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