Batool Sumera, Afridi Muhammad Shakir, Khoja Adeel, Islam Najmul
Dr. Sumera Batool, FCPS. Department of Endocrinology, Agha Khan University Hospital, Karachi, Pakistan.
Dr. Muhammad Shakir Afridi, Final year student MBBS, Agha Khan University Hospital, Karachi, Pakistan.
Pak J Med Sci. 2019 Sep-Oct;35(5):1312-1317. doi: 10.12669/pjms.35.5.704.
As the thyroid cancer incidence is increasing, the search for its risk factor is becoming more important. Serum thyroid stimulating hormone (TSH) levels being a growth factor for normal thyroid tissue, is also considered as growth promotor of cancer cells. In our study we aimed for pre-operative serum TSH levels of Differentiated thyroid cancers (DTC) done before their first surgery and determined its association with advanced disease in terms of stage, multifocal disease, lymph node involvement and distant metastasis.
We have conducted a retrospective review of thyroid cancers from 1 January 2008 to 31 December 2017. Out of 281, 142 cases were included according to inclusion criteria. We noted the demographic details of participants, their histopathological diagnosis and serum TSH levels done before first surgery from the medical records. We calculated the stage of tumor through modified American Joint Committee (AJCC) staging system.
Out of 147 participants, 89.4% had papillary carcinoma or its variants whereas 10.6% reported follicular carcinoma. The mean pre-op TSH level of the patients included was 2.04 ± 1.79. In addition to the descriptive analysis, the univariate regression analysis revealed that the association of serum TSH levels was found to be statistically insignificant with advanced stage of thyroid cancer, multifocal disease, lymph node metastasis and distant metastasis respectively.
The serum TSH levels before surgery was not associated with poor prognosis of differentiated thyroid cancer with respect to higher staging, multifocal disease, lymphatic or distant metastasis.
随着甲状腺癌发病率的上升，寻找其危险因素变得愈发重要。血清促甲状腺激素（TSH）水平作为正常甲状腺组织的生长因子，也被视为癌细胞的生长促进剂。在我们的研究中，我们旨在研究分化型甲状腺癌（DTC）首次手术前的术前血清TSH水平，并确定其与疾病进展在分期、多灶性疾病、淋巴结受累及远处转移方面的关联。
我们对2008年1月1日至2017年12月31日期间的甲状腺癌进行了回顾性研究。根据纳入标准，从281例中纳入了142例。我们从病历中记录了参与者的人口统计学细节、组织病理学诊断以及首次手术前的血清TSH水平。我们通过改良的美国联合委员会（AJCC）分期系统计算肿瘤分期。
在147名参与者中，89.4%患有乳头状癌或其变体，而10.6%报告为滤泡状癌。纳入患者的术前TSH平均水平为2.04±1.79。除描述性分析外，单因素回归分析显示血清TSH水平与甲状腺癌晚期、多灶性疾病、淋巴结转移和远处转移的关联在统计学上均无显著意义。
就更高分期、多灶性疾病、淋巴或远处转移而言，术前血清TSH水平与分化型甲状腺癌的不良预后无关。
