Department of Surgery, MetroHealth Medical Center, 2500 Metrohealth Drive, Cleveland, OH 44109-1998, USA.
Am J Surg. 2010 Mar;199(3):294-7; discussion 298. doi: 10.1016/j.amjsurg.2009.08.028.
The aim of this study was to assess whether serum thyroid-stimulating hormone (TSH) levels are of value in predicting malignancy in patients with nodular thyroid disease (NTD).
Patients with NTD and a preoperative TSH level who underwent thyroidectomy between 1990 and 2008 were identified from a prospective database. Age, sex, TSH concentration, nodule size, and pathology were evaluated. Logistic regression analysis was used to determine which factors were predictive of malignancy.
Six hundred fifty-three patients were analyzed. The overall rate of malignancy was 20%; the rate was highest in patients<30 years (32%). The mean TSH level was higher in the malignant group (5.5 microIU/mL vs 1.4 microIU/mL, P<.0001). The rate of malignancy was 65% in patients with TSH levels>5.5 microIU/mL. Logistic regression analysis revealed that TSH level was the only significant risk factor for malignancy.
The serum TSH level may be useful in predicting the probability of cancer and optimizing the extent of thyroidectomy in patients with NTD.
本研究旨在评估结节性甲状腺疾病（NTD）患者的血清促甲状腺激素（TSH）水平是否有助于预测恶性肿瘤。
从一个前瞻性数据库中确定了 1990 年至 2008 年间接受甲状腺切除术的 NTD 且术前 TSH 水平的患者。评估了年龄、性别、TSH 浓度、结节大小和病理。采用逻辑回归分析确定哪些因素是恶性肿瘤的预测因素。
分析了 653 例患者。恶性肿瘤的总体发生率为 20%；<30 岁的患者发生率最高（32%）。恶性组的平均 TSH 水平较高（5.5 微 IU/mL 比 1.4 微 IU/mL，P<.0001）。TSH 水平>5.5 微 IU/mL 的患者恶性肿瘤发生率为 65%。逻辑回归分析显示，TSH 水平是恶性肿瘤的唯一显著危险因素。
血清 TSH 水平可能有助于预测 NTD 患者癌症的发生概率，并优化甲状腺切除术的范围。
