Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Head Neck. 2014 Jan;36(1):43-6. doi: 10.1002/hed.23252. Epub 2013 Jun 1.
High serum thyroid-stimulating hormone (TSH) is associated with thyroid carcinoma in patients with thyroid nodules. However, previous studies suggests that TSH is not involved in the pathogenesis of small thyroid carcinomas. We performed this study to evaluate serum TSH as a malignancy predictor in the assessment of small thyroid nodules.
We retrospectively analyzed 3791 patients who underwent thyroidectomy. We classified all patients into 3 to 5 groups by serum TSH or nodule size and analyzed the association of serum TSH and risk of papillary thyroid carcinoma (PTC).
The frequency of PTC increased as serum TSH increased. Serum TSH and older age were associated with the risk of PTC in multivariate analysis (p < .0001). In subgroup analysis, the risk of PTC increased as serum TSH increased with thyroid nodules > 1 cm (p < .05).
Serum TSH may not be useful for clinical risk assessment of small thyroid nodules.
高血清促甲状腺激素（TSH）与甲状腺结节患者的甲状腺癌有关。然而，之前的研究表明 TSH 不参与小甲状腺癌的发病机制。我们进行这项研究是为了评估血清 TSH 在评估小甲状腺结节时作为恶性肿瘤预测因子的作用。
我们回顾性分析了 3791 例接受甲状腺切除术的患者。我们根据血清 TSH 或结节大小将所有患者分为 3-5 组，并分析了血清 TSH 与甲状腺乳头状癌（PTC）风险的关系。
随着血清 TSH 的增加，PTC 的频率增加。多变量分析显示，血清 TSH 和年龄较大与 PTC 的风险相关（p<0.0001）。在亚组分析中，随着血清 TSH 的增加，甲状腺结节>1cm 的 PTC 风险也增加（p<0.05）。
血清 TSH 可能对评估小甲状腺结节的临床风险无帮助。
