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Wang Z, Ji X, Zhang H, Sun W. Clinical and molecular features of progressive papillary thyroid microcarcinoma. Int J Surg 2024; 110:2313-2322. [PMID: 38241301 PMCID: PMC11019976 DOI: 10.1097/js9.0000000000001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/09/2024] [Indexed: 01/21/2024]
Abstract
In recent decades, the prevalence of thyroid cancer has risen substantially, with papillary thyroid microcarcinoma (PTMC) constituting over 50% of cases. Although most PTMCs exhibit indolent growth and a favorable prognosis, some present an increased risk of recurrence and an unfavorable prognosis due to high-risk characteristics such as lymph node metastasis, extrathyroidal extension, and distant metastasis. The early identification of clinically progressing PTMC remains elusive. In this review, the authors summarize findings from PTMC progression-related literature, highlighting that factors such as larger tumor size, cervical lymph node metastasis, extrathyroidal extension, younger age, higher preoperative serum thyroid-stimulating hormone levels, family history, and obesity positively correlate with PTMC progression. The role of multifocality in promoting PTMC progression; however, remains contentious. Furthermore, recent studies have shed light on the impact of mutations, such as BRAF and TERT mutations, on PTMC progression. Researchers have identified several mRNAs, noncoding RNAs, and proteins associated with various features of PTMC progression. Some studies propose that peripheral and tumor tissue-infiltrating immune cells could serve as biomarkers for the clinical progression of PTMC. Collectively, these clinical and molecular features offer a rationale for the early detection and the development of precision theranostic strategies of clinically progressive PTMC.
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Affiliation(s)
| | | | - Hao Zhang
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Wei Sun
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
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Zhang X, Tian L, Teng D, Teng W. The Relationship between Thyrotropin Serum Concentrations and Thyroid Carcinoma. Cancers (Basel) 2023; 15:5017. [PMID: 37894384 PMCID: PMC10605180 DOI: 10.3390/cancers15205017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
Thyroid Stimulating Hormone (TSH) is a hormone secreted by the pituitary gland and plays a role in regulating the production and secretion of thyroid hormones by the thyroid gland. This precise feedback loop is essential for maintaining a harmonious balance of thyroid hormones in the body, which are vital for numerous physiological processes. Consequently, TSH serves as a significant marker in assessing thyroid function, and deviations from normal TSH levels may indicate the presence of a thyroid disorder. Thyroid cancer (TC) is the malignant tumor within the endocrine system. In recent years, numerous experts have dedicated their efforts to discovering efficacious biomarkers for TC. These biomarkers aim to improve the accurate identification of tumors with a poor prognosis, as well as facilitate active monitoring of tumors with a more favorable prognosis. The role of TSH in the thyroid gland underscores its potential influence on the occurrence and progression of TC, which has garnered attention in the scientific community. However, due to the limited scope of clinical research and the dearth of high-quality foundational studies, the precise impact of TSH on TC remains unclear. Consequently, we present a comprehensive review of this subject, aiming to offer a valuable reference for future research endeavors.
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Affiliation(s)
| | | | - Di Teng
- Department of Endocrinology and Metabolism, Institute of Endocrine, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang 110001, China; (X.Z.); (L.T.); (W.T.)
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Ren T, Jiang M, Wu J, Zhang F, Zhang C. Clinical value of grayscale ultrasound combined with real-time shear wave elastography nomogram in risk prediction of thyroid cancer. BMC Med Imaging 2023; 23:123. [PMID: 37700270 PMCID: PMC10496161 DOI: 10.1186/s12880-023-01099-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/06/2023] [Indexed: 09/14/2023] Open
Abstract
OBJECTIVES This study constructed a nomogram based on grayscale ultrasound features and real-time shear wave elastography (SWE) parameters to predict thyroid cancer. METHODS Clinical data of 217 thyroid nodules of 201 patients who underwent grayscale ultrasound, real-time SWE, and thyroid function laboratory examination in Ma'anshan People's Hospital from January 2019 to December 2020 were retrospectively analyzed. The subjects were divided into a benign nodule group (106 nodules) and a malignant nodule group (111 nodules). The differences in grayscale ultrasound features, quantitative parameters of real-time SWE, and laboratory results of thyroid function between benign and malignant thyroid nodules were analyzed. We used a chi-square test for categorical variables and a t-test for continuous variables. Then, the independent risk factors for thyroid cancer were analyzed using multivariate logistic regression. Based on the independent risk factors, a nomogram for predicting thyroid cancer risk was constructed using the RMS package of the R software. RESULTS Multivariate logistic regression showed that the grayscale ultrasound features of thyroid nodules were the shape, margin, echogenicity, and echogenic foci of the nodules,the maximum Young's modulus (SWE-max) of thyroid nodules, and the ratio of thyroid nodule and peripheral gland (SWE-ratio) measured by real-time SWE were independent risk factors for thyroid cancer (all p < 0.05), and the other variables had no statistical difference (p > 0.05). Based on the shape (OR = 5.160, 95% CI: 2.252-11.825), the margin (OR = 9.647, 95% CI: 2.048-45.443), the echogenicity (OR = 6.512, 95% CI: 1.729-24.524), the echogenic foci (OR = 2.049, 95% CI: 1.118-3.756), and the maximum Young's modulus (SWE-max) (OR = 1.296, 95% CI: 1.140-1.473), the SWE-ratio (OR = 2.001, 95% CI: 1.403-2.854) of the thyroid nodule to peripheral gland was used to establish the related nomogram prediction model. The bootstrap self-sampling method was used to verify the model. The consistency index (C-index) was 0.979, ROC curve was used to analyze the nomogram scores of all patients, and the AUC of nomogram prediction of thyroid cancer was 0.976, indicating that the nomogram model had high accuracy in the risk prediction of thyroid cancer. CONCLUSIONS The nomogram model of grayscale ultrasound features combined with SWE parameters can accurately predict thyroid cancer.
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Affiliation(s)
- Tiantian Ren
- Department of Medical Ultrasound, Maanshan People’s Hospital, Hubei Road, Anhui Maanshan, 243032 China
| | - Mingfei Jiang
- School of Public Health, Southeast University, Hunan Road, Nanjing, Jiangsu 210000 China
| | - Jiawei Wu
- Department of Medical Ultrasound, Maanshan People’s Hospital, Hubei Road, Anhui Maanshan, 243032 China
| | - Fan Zhang
- Department of Medical Ultrasound, Maanshan People’s Hospital, Hubei Road, Anhui Maanshan, 243032 China
| | - Chaoxue Zhang
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Meishan Road, AnHui Hefei, 230000 China
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Liu W, Zhang D, Jiang H, Peng J, Xu F, Shu H, Su Z, Yi T, Lv Y. Prediction model of cervical lymph node metastasis based on clinicopathological characteristics of papillary thyroid carcinoma: a dual-center retrospective study. Front Endocrinol (Lausanne) 2023; 14:1233929. [PMID: 37766691 PMCID: PMC10519787 DOI: 10.3389/fendo.2023.1233929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Background The overall prevalence of papillary thyroid carcinoma (PTC) patients is expanding along with an ongoing increase in thyroid cancer incidence. Patients with PTC who have lymph node metastases have a poor prognosis and a high death rate. There is an urgent need for indicators that can predict lymph node metastasis (LNM) before surgery as current imaging techniques, such as ultrasonography, do not have sufficient sensitivity to detect LNM. To predict independent risk factors for Central lymph node metastasis (CLNM) or Lateral lymph node metastasis (LLNM), we therefore developed two nomograms based on CLNM and LLNM, separately. Methods In two centers, the Second Affiliated Hospital of Nanchang University and Yichun People's Hospital, we retrospectively analyzed clinicopathological characteristics of PTC patients. We utilized multivariate analysis to screen for variables that might be suspiciously related to CLNM or LLNM. Furthermore, we developed nomograms to graphically depict the independent risk valuables connected to lymph node metastasis in PTC patients. Result Ultimately, 6068 PTC patients in all were included in the research. Six factors, including age<45, male, mETE, TSH>1.418, tumor size>4cm, and location (multicentric and lobe), were observed to be related to CLNM. Age<45, male, mETE (minimal extrathyroidal extension), multifocality, TSH≥2.910, CLNM positive, and tumor size>4cm were regarded as related risk factors for LLNM. The two nomograms developed subsequently proved to have good predictive power with 0.706 and 0.818 and demonstrated good clinical guidance functionality with clinical decision curves and impact curves. Conclusion Based on the successful establishment of this dual-institution-based visual nomogram model, we found that some clinical features are highly correlated with cervical lymph node metastasis, including CLNM and LLNM, which will better help clinicians make individualized clinical decisions for more effectively rationalizing managing PTC patients.
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Affiliation(s)
- Wenji Liu
- Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Second Clinical Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Die Zhang
- Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Medical Department, The First Clinical Medicine College, Nanchang University, Nanchang, Jiangxi, China
| | - Hui Jiang
- Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Second Clinical Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Jie Peng
- Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Second Clinical Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Fei Xu
- Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Second Clinical Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Hongxin Shu
- Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Second Clinical Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Zijian Su
- Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Medical Department, The First Clinical Medicine College, Nanchang University, Nanchang, Jiangxi, China
| | - Tao Yi
- Department of Otolaryngology, Yichun People’s Hospital, Yichun, Jiangxi, China
| | - Yunxia Lv
- Department of Thyroid Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Zhao H, Hu J, Cui L, Gong Y, Huang T. Association between iodine nutrition and cervical lymph node metastasis of papillary thyroid microcarcinoma. Front Endocrinol (Lausanne) 2023; 14:1164069. [PMID: 37720525 PMCID: PMC10500345 DOI: 10.3389/fendo.2023.1164069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 08/09/2023] [Indexed: 09/19/2023] Open
Abstract
We aimed to investigate the association between iodine intake and nodal metastasis stratified by central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) of papillary thyroid microcarcinoma (PTMC). Urinary iodine concentration (UIC) and clinicopathological characteristics were used to identify factors associated with CLNM and LLNM using logistic regression analysis. A sum of 3,858 PTMC patients were enrolled. The median UIC (MUI) of patients with CLNM or LLNM was not statistically different from those without nodal metastasis. Male patients had a higher MUI than females (183.4 μg/L vs. 173.6 μg/L). Female patients with extracapsular extension had a higher MUI than those without it (210.0 μg/L vs. 172.1 μg/L). Male patients with LLNM had a significantly lower MUI than those without LLNM (134.7 μg/L vs. 187.9 μg/L). Female patients with more than adequate iodine intake were more likely to present with CLNM and extrathyroidal extension than those with adequate iodine intake with an odds ratio (95% confidence interval) of 1.23 (1.01-1.51) and 1.59 (1.09-2.32) after adjustment. Iodine nutrition was not found to be associated with LLNM. In addition, patients with a younger age, larger tumors, extrathyroidal extension, and intrathyroidal spread were more likely to be CLNM, whereas nodular goiter presented with a protective factor; CLNM was the only factor associated with LLNM of PTMC in both genders. In conclusion, iodine nutrition has a much closer association with female than male patients, and high iodine intake may be associated with CLNM and extrathyroidal extension in female PTMC patients.
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Affiliation(s)
- Hengqiang Zhao
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jin Hu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Le Cui
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yiping Gong
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tao Huang
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Liu XN, Duan YS, Yue K, Wu YS, Zhang WC, Wang XD. The optimal extent of lymph node dissection in N1b papillary thyroid microcarcinoma based on clinicopathological factors and preoperative ultrasonography. Gland Surg 2022; 11:1047-1056. [PMID: 35800750 PMCID: PMC9253184 DOI: 10.21037/gs-22-284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/13/2022] [Indexed: 03/26/2024]
Abstract
BACKGROUND The optimal extent of lymph node (LN) dissection in the management of N1b papillary thyroid microcarcinoma (PTMC) is still under debate in clinical practice, so we aimed to identify the risk factors associated with multilevel lateral lymph node metastasis (LLNM) with regard to the extent of LN dissection. METHODS The clinical data of 182 N1b PTMC patients between January 2019 and June 2021 at Tianjin Medical University Cancer Institute and Hospital were retrospectively reviewed. The frequency pattern and distribution of LLNM were analyzed for risk factors. We assessed the diagnostic value of preoperative ultrasonography (USG) for identifying levels II-V metastasis in PTMC patients. RESULTS The proportion of multilevel LLNM in N1b PTMC was 72.1%, and the most common pattern was metastasis at two levels (41.2%). Capsule invasion [odds ratio (OR) =6.861, 95% confidence interval (CI): 1.462-32.190, P=0.015], upper pole [OR =2.125, 95% CI: 1.010-4.473, P=0.047], central LN ratio [OR =7.315, 95% CI: 1.309-40.877, P=0.023], thyroid-stimulating hormone (TSH) >1.5 mIU/mL [OR =2.773, 95% CI: 1.269-6.060, P=0.011], and extranodal extension (ENE) [OR =2.632, 95% CI: 1.207-5.739, P=0.015] were independent risk factors for multilevel metastasis. In addition, unltrasonography had high sensitivity and specificity in the diagnosis of metastasis at level V (75.0%, 78.4%) and multilevel LLNM (67.2%, 64.8%). CONCLUSIONS Modified radical neck dissection (MRND) in N1b PTMC patients may be reserved for patients with simultaneous 3-level LLNM or clinically evident metastasis at level V. Preoperative USG may have certain suggestive significance in the diagnosis of multilevel LLNM in primary PTMC.
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Affiliation(s)
- Xiao-Nan Liu
- Department of Maxillofacial & E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- Department of Thyroid and Breast Surgery, Tianjin 4th Center Hospital, Tianjin, China
| | - Yuan-Sheng Duan
- Department of Maxillofacial & E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Kai Yue
- Department of Maxillofacial & E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Yan-Sheng Wu
- Department of Maxillofacial & E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Wen-Chao Zhang
- Department of Maxillofacial & E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Xu-Dong Wang
- Department of Maxillofacial & E.N.T. Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin, China
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Benvenga S, Famà F, Perdichizzi LG, Antonelli A, Brenta G, Vermiglio F, Moleti M. Fish and the Thyroid: A Janus Bifrons Relationship Caused by Pollutants and the Omega-3 Polyunsaturated Fatty Acids. Front Endocrinol (Lausanne) 2022; 13:891233. [PMID: 35712237 PMCID: PMC9196333 DOI: 10.3389/fendo.2022.891233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/21/2022] [Indexed: 12/20/2022] Open
Abstract
Benefits of the omega-3 polyunsaturated fatty acids (PUFA) on a number of clinical disorders, including autoimmune diseases, are widely reported in the literature. One major dietary source of PUFA are fish, particularly the small oily fish, like anchovy, sardine, mackerel and others. Unfortunately, fish (particularly the large, top-predator fish like swordfish) are also a source of pollutants, including the heavy metals. One relevant heavy metal is mercury, a known environmental trigger of autoimmunity that is measurable inside the thyroid. There are a number of interactions between the omega-3 PUFA and thyroid hormones, even at the level of the thyroid hormone transport proteins. Concerning the mechanisms behind the protection from/amelioration of autoimmune diseases, including thyroiditis, that are caused by the omega-3 PUFA, one can be the decreased production of chemokines, a decrease that was reported in the literature for other nutraceuticals. Recent studies point also to the involvement of resolvins. The intracellular increase in resolvins is associated with the tissue protection from inflammation that was observed in experimental animals after coadministration of omega-3 PUFA and thyroid hormone. After having presented data on fish consumption at the beginning, we conclude our review by presenting data on the market of the dietary supplements/nutraceuticals. The global omega-3 products market was valued at USD 2.10 billion in 2020, and was projected to go up at a compound annual growth rate of 7.8% from 2020 to 2028. Among supplements, fish oils, which are derived mainly from anchovies, are considered the best and generally safest source of omega-3. Taking into account (i) the anti-autoimmunity and anti-cancer properties of the omega-3 PUFA, (ii) the increasing incidence of both autoimmune thyroiditis and thyroid cancer worldwide, (iii) the predisposing role for thyroid cancer exerted by autoimmune thyroiditis, and (iv) the risk for developing metabolic and cardiovascular disorders conferred by both elevated/trendwise elevated serum TSH levels and thyroid autoimmunity, then there is enough rationale for the omega-3 PUFA as measures to contrast the appearance and/or duration of Hashimoto's thyroiditis as well as to correct the slightly elevated serum TSH levels of subclinical hypothyroidism.
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Affiliation(s)
- Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Fausto Famà
- Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
- *Correspondence: Fausto Famà, ;
| | | | - Alessandro Antonelli
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Gabriela Brenta
- Division of Endocrinology, Dr. Cesar Milstein Hospital, Buenos Aires, Argentina
| | - Francesco Vermiglio
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Mariacarla Moleti
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Soleimanisardoo L, Rouhani M, Sardoo FS, Gozashti MH. The Effect of ThyroidߚStimulating Hormone on Stage of Differentiated Thyroid Carcinoma. ENDOCRINOLOGY DIABETES & METABOLISM 2021; 4:e00266. [PMID: 34277989 PMCID: PMC8279600 DOI: 10.1002/edm2.266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/21/2021] [Accepted: 05/07/2021] [Indexed: 12/18/2022]
Abstract
Introduction Thyroid cancer is the most common endocrine malignancy, and it has the fastest increase rate in incidence in both sexes, with a yearly increase of 3% over the last decade. Thyroid‐stimulating hormone (TSH) is the main driver for the thyroid gland to produce thyroid hormone. The main purpose of this study was to assess the relationship between serum TSH level and the stage of malignancy in patients with differentiated thyroid cancer. Methods This cross‐sectional study was performed on 77 patients with thyroid cancer. The demographic characteristics, TSH level and stage of malignancy were recorded for all patients in the data collection form. The data analysis was conducted by descriptive statistics using SPSS 20.0 software. Results The results show a significant relationship (p‐value = .025) between the malignancy stage and serum TSH level. The mean TSH level in patients of stage 3 (5.70 ± 2.03) was significantly higher than patients in stage 2 (2.58 ± 0.52) and stage 1 (2.33 ± 0.28). No significant relationship was observed between the age of patients and serum TSH level. Although the mean serum TSH level in men (3.61 ± 0.98) was higher than in women (2.52 ± 0.25), the difference was not statistically significant. Conclusions According to the results of this study, serum TSH level can be considered as a predictor of the stage of differentiated thyroid cancer. Therefore, it can be used to predict the likelihood of cancer and improve the outcome and extent of thyroidectomy in patients with thyroid cancer. Thyroid‐stimulating hormone (TSH) is the main driver for the thyroid gland to produce thyroid hormone. The main purpose of this study is to assess the relationship between serum TSH level and the stage of malignancy in patients with differentiated thyroid cancer.
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Affiliation(s)
- Laya Soleimanisardoo
- Endocrine and Metabolism Research Center Institute of Basic and Clinical Physiology Sciences Kerman University of Medical Sciences Kerman Iran
| | - Mohsen Rouhani
- Endocrine and Metabolism Research Center Institute of Basic and Clinical Physiology Sciences Kerman University of Medical Sciences Kerman Iran
| | - Fatemeh Soleymani Sardoo
- Pathology and Stem Cell Research Center Afzalipour Hospital Kerman University of Medical Sciences Kerman Iran
| | - Mohammad Hossein Gozashti
- Endocrine and Metabolism Research Center Institute of Basic and Clinical Physiology Sciences Kerman University of Medical Sciences Kerman Iran
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