The Midwest Surgical AssociationThe utility of preoperative serum thyroid-stimulating hormone level for predicting malignant nodular thyroid disease
Section snippets
Methods
Patients with NTD who underwent thyroidectomy during the period from 1990 to 2008 were evaluated. Fine-needle aspiration (FNA) biopsy was performed for thyroid nodules ≥1 cm in size or nodules <1 cm with abnormal sonographic features. Cytologic results were classified into the following categories: benign, malignant, indeterminate (follicular neoplasm, Hurthle cell neoplasm, and suspicious for papillary cancer), and nondiagnostic (insufficient cells for diagnosis). Thyroidectomy was recommended
Results
There were 653 patients identified from the database who met the inclusion criteria. Five hundred sixty (86%) were women, and the mean age of the study population was 49 ± 16 years. There were 74 patients <30 years of age, 260 patients between 30 years and 50 years, 246 patients between 51 and 70, and 71 patients older than 70 years.
Five hundred thirty-six patients had an FNA biopsy; 52 were malignant, 184 benign, 221 indeterminate, and 59 were persistently nondiagnostic. All 653 patients had
Comments
In this study, we were able to show that higher serum TSH levels correlate with a higher risk of malignancy in patients with NTD, corroborating the results of similar studies.7, 8, 9, 10 The relationship of serum TSH level and cancer identified in our series was independent of age and sex. Haymart et al9 have also found that advanced-stage thyroid cancer was associated with higher mean serum TSH levels. Furthermore, Haymart et al have identified a relationship between higher serum TSH levels
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