scholarly journals Thyroid Hormones, Autoantibodies, Ultrasonography, and Clinical Parameters for Predicting Thyroid Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Lin-zheng He ◽  
Tian-shu Zeng ◽  
Lin Pu ◽  
Shi-xiu Pan ◽  
Wen-fang Xia ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Characteristic Curve ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Preoperative Serum ◽  
Thyroglobulin Antibody ◽  
Increased Risk ◽  
Risk Of Malignancy ◽  
Punctate Calcification ◽  
Serum Tsh

Our objective was to evaluate thyroid nodule malignancy prediction using thyroid function tests, autoantibodies, ultrasonographic imaging, and clinical data. We conducted a retrospective cohort study in 1400 patients with nodular thyroid disease (NTD). The thyroid stimulating hormone (TSH) concentration was significantly higher in patients with differentiated thyroid cancer (DTC) versus benign thyroid nodular disease (BTND) (p=0.004). The receiver operating characteristic curve of TSH showed an AUC of 0.58 (95% CI 0.53–0.62,p=0.001), sensitivity of 74%, and specificity of 57% at a cut-off of 1.59 mIU/L. There was an incremental increase in TSH concentration along with the increasing tumor size (p<0.001). Thyroglobulin antibody (TgAb) concentration was associated with an increased risk of malignancy (p=0.029), but this association was lost when the effect of TSH was taken into account (p=0.11). Thyroid ultrasonographic characteristics, including fewer than three nodules, hypoechoic appearance, solid component, poorly defined margin, intranodular or peripheral-intranodular flow, and punctate calcification, can be used to predict the risk of thyroid cancer. In conclusion, our study suggests that preoperative serum TSH concentration, age, and ultrasonographic features can be used to predict the risk of malignancy in patients with NTD.

scholarly journals Utility of recombinant human TSH stimulation test in the follow-up of patients with differentiated thyroid cancer depending on basal thyroglobulin results

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Amaia Sandúa ◽  
Monica Macias ◽  
Carolina Perdomo ◽  
Juan Carlos Galofre ◽  
Roser Ferrer ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Thyroid Stimulating Hormone ◽  
Stimulation Test ◽  
Human Thyroid ◽  
Antithyroglobulin Antibodies ◽  
Structural Disease

AbstractBackgroundThyroglobulin (Tg) is fundamental for differentiated thyroid cancer (DTC) monitoring. Tg detection can be enhanced using recombinant human thyroid-stimulating hormone (TSH) (rhTSH). This study is aimed to evaluate the use of the rhTSH stimulation test when using a high-sensitivity Tg assay.MethodsWe retrospectively studied 181 rhTSH tests from 114 patients with DTC and negative for antithyroglobulin antibodies (anti-TgAb). Image studies were performed in all cases. Serum Tg and anti-TgAb were measured using specific immunoassays.ResultsrhTSH stimulation in patients with basal serum Tg (b-Tg) concentrations lower than 0.2 ng/mL always resulted in rhTSH-stimulated serum Tg (s-Tg) concentrations lower than 1.0 ng/mL and negative structural disease. In patients with b-Tg concentration between 0.2 and 1.0 ng/mL, s-Tg detected one patient (1/30) who showed biochemical incomplete response. Patients with negative images had lower s-Tg than those with nonspecific or abnormal findings (p<0.05). Receiver operating characteristic curve analysis of the s-Tg to detect altered images showed an area under the curve of 0.763 (p<0.05). With an s-Tg cutoff of 0.85 ng/mL, the sensitivity was 100%, decreasing to 96.15% with an s-Tg cutoff of 2 ng/mL.ConclusionsPatients with DTC with b-Tg concentrations equal or higher than 0.2 ng/mL can benefit from the rhTSH stimulation test.

Subclinical hypothyroidism

2011 ◽  
pp. 543-547
Author(s):  
Jayne A. Franklyn
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Expert Panel ◽  
Elevated Serum ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Thyroid Function Tests ◽  
Free Triiodothyronine ◽  
Function Tests ◽  
Serum Tsh

Subclinical hypothyroidism is defined biochemically as the association of a raised serum thyroid-stimulating hormone (TSH) concentration with normal circulating concentrations of free thyroxine (T4) and free triiodothyronine (T3). The term subclinical hypothyroidism implies that patients should be asymptomatic, although symptoms are difficult to assess, especially in patients in whom thyroid function tests have been checked because of nonspecific complaints such as tiredness. An expert panel has recently classified individuals with subclinical hypothyroidism into two groups (1): (1) those with mildly elevated serum TSH (typically TSH in the range 4.5–10.0 mU/l) and (2) those with more marked TSH elevation (serum TSH >10.0 mU/l).

scholarly journals The association between serum TSH concentration and thyroid cancer

2009 ◽  
Vol 16 (4) ◽  
pp. 1065-1072 ◽  
Author(s):  
Kristien Boelaert
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Disease ◽  
Potential Role ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Preoperative Serum ◽  
Lower Baseline ◽  
New Findings ◽  
The Relationship ◽  
Serum Tsh

There is mounting evidence that the serum concentration of TSH is an independent predictor for the diagnosis of thyroid malignancy in patients with nodular thyroid disease. Furthermore, preoperative serum TSH concentrations are higher in patients with more aggressive tumours, suggesting a potential role for TSH in the progression of differentiated thyroid cancer. Based on these observations, patients with higher serum TSH concentrations and borderline cytological results may require more aggressive investigation and treatment when compared with those with lower baseline TSH levels. The mechanisms underlying the finding of higher serum TSH in patients with thyroid cancer remain unexplained. In this issue of Endocrine-Related Cancer, Fiore et al. have analysed the relationship between serum TSH and diagnosis of papillary thyroid cancer in 10 178 patients with nodular thyroid disease who were investigated by fine-needle aspiration biopsy. They found significantly higher TSH concentrations in patients who were subsequently diagnosed with thyroid cancer compared with those with benign disease. In addition, they found that the development of autonomous thyroid function (TSH<0.4 μU/ml) was associated with a reduction in the risk of papillary thyroid carcinoma. In this commentary, the evidence regarding the association between serum TSH and thyroid cancer is discussed placing these new findings into context.

scholarly journals The effect of iodine in patients using povidone-iodine mouth wash on thyroid function

2019 ◽  
Vol 5 (6) ◽  
pp. 1562 ◽  
Author(s):  
Gowri Shankar Murugesan ◽  
Manju Priya Venkat
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Povidone Iodine ◽  
Endocrine System ◽  
Thyroid Stimulating Hormone ◽  
Increased Risk ◽  
Before And After ◽  
Mouth Wash ◽  
Serum Tsh ◽  
Stimulating Hormone

<p class="abstract"><strong>Background:</strong> Thyroid gland is a key part of endocrine system and it performs its functions via two most important thyroid hormones thyroxine (T4) and triiodothyronine (T3). Thyroid gland is mainly regulated by thyroid-stimulating hormone (TSH). Povidone-iodine (polyvinylpyrrolidone-iodine, PVP-I) mouthwash is commonly used to treat infections of the oral cavity and oropharynx and iodine released from PVP-I can interfere with thyroid function. In this study the effect of brief treatment with povidone-iodine mouth wash on thyroid function was assessed. The aim of the present study was to assess whether iodine is absorbed through oral transmucosal route and interfere with TSH in serum.</p><p class="abstract"><strong>Methods:</strong> Fifty one patients with acute and chronic pharyngitis and tonsillitis were recruited and out of which forty-seven patients were treated with 20 ml of PVP-I mouthwash twice daily for 3 weeks and blood was collected from the respective patients before and after treatment with PVP-I. Serum thyroid stimulating hormone concentration was measured from the collected blood samples of the patients.</p><p class="abstract"><strong>Results:</strong> In the present study there was a small increase in serum TSH concentration during the therapy with PVP-I but the concentration determined was within the normal range.</p><p class="abstract"><strong>Conclusions:</strong> Based on the results of this study we conclude that the use of PVP-I for a brief period transiently increase TSH value and prolonged use should be avoided in people with an increased risk of thyroid dysfunction and other autoimmune disorders.</p>

scholarly journals Thyroid dysfunction in preterm infants born before 32 gestational weeks

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hye-Rim Kim ◽  
Young Hwa Jung ◽  
Chang Won Choi ◽  
Hye Rim Chung ◽  
Min-Jae Kang ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Thyroid Dysfunction ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Academic Center ◽  
Pituitary Thyroid Axis ◽  
Thyroid Axis ◽  
Delayed Maturation ◽  
Levothyroxine Treatment ◽  
Serum Tsh

Abstract Background Thyroid hormones are critical for growth and brain development during the newborn period and infancy. Because of delayed maturation of the hypothalamic-pituitary-thyroid axis in preterm infants, thyroid dysfunction is common, and thyroid stimulating hormone (TSH) elevation is often delayed in preterm infants. The objective of this study was to determine the incidence of thyroid dysfunction requiring levothyroxine treatment and to identify its risk factors in preterm infants. Methods A retrospective cohort study was performed on preterm infants who were born before 32 gestational weeks and admitted to a single tertiary academic center for more than 8 weeks between January 2008 and December 2014. In these infants, serial thyroid function tests (TFTs) measuring serum TSH and free thyroxine (fT4) were routinely performed at 1, 3, and 6 weeks of postnatal age. Results Of the 220 preterm infants enrolled, 180 infants underwent TFTs at 1, 3, and 6 weeks of postnatal age and were included in the study. Of the 180 infants, 35 infants (19.4%) were started on levothyroxine treatment based on the results of serial TFTs. Among the 35 infants who were treated with levothyroxine, 16 infants (45.7%) had normal results on the initial TFT. Three of these 16 infants continued to have normal results on the second TFT. Thyroid dysfunction requiring levothyroxine treatment was significantly associated with maternal pregnancy-induced hypertension (adjusted odds ratio 2.64, 95% confidence interval 1.02–6.81). Conclusions Thyroid dysfunction requiring levothyroxine treatment occurred in nearly one-fifth of preterm infants born before 32 gestational weeks. Nearly half of the preterm infants who were treated with levothyroxine had normal TSH and fT4 levels at 1 week of postnatal age. The findings of the present study suggest that serial TFTs is important to find preterm infants who require levothyroxine treatment.

DEVELOPMENT AND INTERNAL VALIDATION OF A PREDICTIVE MODEL FOR INDIVIDUAL CANCER RISK ASSESSMENT FOR THYROID NODULES

2020 ◽  
Vol 26 (10) ◽  
pp. 1077-1084
Author(s):  
Florentino Carral San Laureano ◽  
Juan Jesús Fernández Alba ◽  
José Manuel Jiménez Heras ◽  
Ana Isabel Jiménez Millán ◽  
Mariana Tomé Fernández-Ladreda ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Confidence Interval ◽  
Predictive Model ◽  
Thyroid Nodules ◽  
Cross Validation ◽  
Thyroid Stimulating Hormone ◽  
Individual Risk ◽  
Risk Of Malignancy ◽  
The Individual ◽  
Stimulating Hormone

Objective: The objective of this study was to develop and validate a predictive model for the assessment of the individual risk of malignancy of thyroid nodules based on clinical, ultrasound, and analytic variables. Methods: A retrospective case-control study was carried out with 542 patients whose thyroid nodules were analyzed at our endocrinology department between 2013 and 2018 while undergoing treatment for thyroidectomy. Starting with a multivariate logistic regression analysis, which included clinical, analytic, and ultrasound variables, a predictive model for thyroid cancer (TC) risk was devised. This was then subjected to a cross-validation process, using resampling techniques. Results: In the final model, the independent predictors of the risk of malignancy were: being male, age of the extremes, family history of TC, thyroid-stimulating hormone level >4.7 μU/L, presence of autoimmune thyroiditis, solid consistency, hypoechogenicity, irregular or microlobed borders, nodules that are taller than they are wide, microcalcifications, and suspicious adenopathy. With a cut-off point of 50% probability of thyroid cancer, the predictive model had an area under the receiver operating characteristic curve of 0.925 (95% confidence interval 0.898 to 0.952). Finally, using the 10-fold cross-validation method, the accuracy of the model was found to be 88.46%, with a kappa correlation coefficient of 0.62. Conclusion: A predictive model for the individual risk of malignancy of thyroid nodules was developed and validated using clinical, analytic, and ultrasound variables. An online calculator was developed from this model to be used by clinicians to improve decision-making in patients with thyroid nodules. Abbreviations: ATA = American Thyroid Association; CI = confidence interval; FNA = fine needle aspiration; TC = thyroid cancer; TSH = thyroid-stimulating hormone

scholarly journals A study of association between serum thyroid stimulating hormone concentration and thyroid cancer and also to assess whether serum thyroid stimulating hormone levels are of value in predicting malignancy in patients with thyroid swelling

2021 ◽  
Author(s):  
Benny Bright ◽  
Joe Mathew ◽  
Jacob P. Thomas ◽  
Robinson George
Keyword(s):  
Thyroid Cancer ◽  
Papillary Carcinoma ◽  
Thyroid Nodules ◽  
Malignant Tumors ◽  
Independent Predictor ◽  
Medical Science ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Malignancy ◽  
Serum Tsh ◽  
Stimulating Hormone

Background: Thyroid neoplasm includes both benign and malignant tumors arising in the thyroid gland. Although thyroid cancer accounts for less than 1% of all cancers, the challenge to clinicians is to identify the minority of thyroid nodules that harbor malignancy. There are a number of well-established predictors of malignancy in thyroid nodules. More recently a few studies have suggested that higher concentration of thyroid stimulating hormone (TSH), even within the normal range are associated with subsequent diagnosis of thyroid cancer in patients with thyroid nodules and even higher serum TSH levels have been found associated with advanced stages of thyroid cancer. Methods: A prospective study was conducted on 220 cases without overt thyroid dysfunction attending Department of general surgery, Pushpagiri institute of medical science, Thiruvalla.  Results: In our study incidence of malignancy of thyroid carcinoma was highest in patients with serum TSH concentrations, in range of 3.5 mIU/l-5.25 mIU/l, 55 patients out of 220 patients. Individually, incidence of papillary carcinoma (PC) (36/55 patients), follicular carcinoma (FC) (17/55 patients) and Hurthle cell carcinoma (HCC) (2/55 patients) were more in patients with higher TSH. So, from the study it can be clearly state that elevated TSH can be used as an independent predictor of thyroid malignancy. Higher TSH values are associated with papillary thyroid carcinoma.Conclusions: An elevated TSH can be used as an independent predictor of thyroid malignancy, especially for anticipating a probability of papillary carcinoma of thyroid.  

scholarly journals Comparative study on association between serum TSH concentration and Thyroid cancer

2017 ◽  
Vol 4 (8) ◽  
pp. 2800
Author(s):  
Prasad C. ◽  
Supreet Kumar ◽  
Tej Tej Y.
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Tertiary Care ◽  
Follicular Carcinoma ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Thyroid Malignancy ◽  
Tertiary Care Centre ◽  
Serum Tsh ◽  
Tsh Levels

Background: In India, thyroid cancer accounts for less than 1% of all malignancies (2% of women and 0.5% of men). Thyroid cancer is responsible for 6 deaths per 1 million persons annually. Serum TSH is a well-established growth factor for thyroid nodules, however its role in thyroid malignancy is inconclusive hence this study was conducted with the objective to determine the association between serum Thyroid stimulating hormone (TSH) concentrations with thyroid carcinoma.Methods: Case control study was conducted in a tertiary care centre. 120 Benign and malignant thyroid subjects respectively were included in the study. Newly diagnosed and record based data collection was done. Measurements of serum TSH concentrations were performed by automated immune chemiluminescent assay. Data was analyzed using SPSS 22 version software, Chi-square test was used as test of significance for qualitative data, p value of <0.05 was considered as statistically significant.Results: Majority of them were females in the age group 26 to 40 years in both the groups and were diagnosed to have solitary thyroid nodule. In malignant thyroid nodules 51.7% were diagnosed to have follicular carcinoma, 46.7% had papillary carcinoma and 1.7% were diagnosed to have Hurthle cell carcinoma. Significant association was observed between TSH levels and diagnosis of thyroid lesions. TSH was raised (>4mIU/L) in 46.6% of malignant nodules and in 15% of benign nodules. Raised TSH had an odds ratio of 4.958 for Thyroid malignancy compared to benign nodulesConclusions: Higher TSH levels were associated with Thyroid malignancy and the risk of malignancy rises in parallel with serum TSH within normal range, and high levels of serum TSH concentrations was associated with advanced stage of thyroid cancer. 

scholarly journals Pattern analysis for prognosis of differentiated thyroid cancer according to preoperative serum thyrotropin levels

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hosu Kim ◽  
Jaehoon Jung ◽  
Young-Seok Cho ◽  
Joon Young Choi ◽  
Hyunju Park ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Distant Metastasis ◽  
Tumor Size ◽  
Primary Tumor ◽  
Differentiated Thyroid Cancer ◽  
Pattern Analysis ◽  
Primary Tumor Size ◽  
Preoperative Serum ◽  
Serum Tsh ◽  
Tsh Levels

AbstractSerum thyrotropin (TSH) level after thyroid surgery affects the prognosis of differentiated thyroid cancer (DTC). However, the effects of preoperative serum TSH levels on the prognosis of DTC remain contradictory. In this study, to better understand the relationship between preoperative TSH levels and the prognosis of DTC, we performed pattern analysis of prognostic factors of DTC according to preoperative serum TSH levels. We retrospectively reviewed the clinical records of patients who were diagnosed and treated for DTC at the Samsung Medical Center, between 1994 and 2016. We reviewed preoperative serum TSH levels and performed a pattern analysis with prognostic risk factors for DTC. For pattern analysis, TSH was divided into 10 groups of equal fractions (TSH decile). We found a linear association between preoperative TSH levels and extra-thyroidal extension and lymph node metastasis. However, primary tumor size and initial distant metastasis showed a bimodal peak, which was similar to the pattern of overall and disease-specific death. We found that preoperative TSH range which showed the lowest mortality rate was about 0.8 to 1.59 mIU/L, which are slightly lower normal TSH levels. Although there was no linear trend, the primary tumor size, initial distant metastasis, and mortality of DTC were closely related with preoperative TSH decile and they showed a bimodal pattern. The results obtained in this study provide additional information for understanding the association between preoperative TSH levels and DTC prognosis.

scholarly journals AMIODARONE-INDUCED THYROTOXICOSIS AFTER TOTAL THYROIDECTOMY FOR METASTATIC FOLLICULAR THYROID CANCER

2020 ◽  
Vol 6 (2) ◽  
pp. e70-e72
Author(s):  
Christerlyn Charles ◽  
Ketan K. Dhatariya
Keyword(s):  
Myocardial Infarction ◽  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Reference Range ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Thyroid Function Tests ◽  
Follicular Thyroid Cancer ◽  
Free Triiodothyronine ◽  
Positron Emission

Objective: To describe the case of a man who developed amiodarone-induced thyrotoxicosis (AIT) after a total thyroidectomy for metastatic follicular thyroid cancer because of the effect of the drug on metastasis. To the best of our knowledge this is the first reported case of this condition. Methods: We completed a retrospective review of medical records and laboratory results including thyroid function tests as well as imaging reports including plain radiographs, positron emission tomographs, computed tomographs, and histology reports. Results: A 78-year-old man had undergone a total thyroidectomy for follicular thyroid cancer. He had meta-static disease in his chest and vertebrae, and after the operation he was started on suppressive levothyroxine treatment prior to ablative radioactive iodine treatment. Prior to thyroidectomy, his thyroid-stimulating hormone (TSH) concentration was 3.21 mU/L (reference range is 0.35 to 3.50 mU/L). On suppressive thyroxine replacement, his TSH concentration was 0.02 mU/L, his free thyroxine was 13 pmol/L (reference range is 8 to 12 pmol/L), and free triiodothyronine was 5.8 pmol/L (reference range is 3.8 to 6.0 pmol/L). He subsequently had a myocardial infarction and required antiarrhythmic treatment with amiodarone. Eleven days later he developed the clinical and biochemical features of thyrotoxicosis (TSH <0.01 mU/L, free thyroxine of 41 pmol/L, and free triiodothyronine of 14.7 pmol/L). His thyroxine dose was reduced and then discontinued 3 days later. AIT was the principal differential diagnosis, but before being able to determine the nature of the condition he died 18 days after his myocardial infarction. Conclusion: AIT can still occur after total thyroidectomy if metastatic tissue is present.

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