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Is serum TSH a biomarker of thyroid carcinoma in patients residing in a mildly iodine-deficient area?

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Abstract

Purpose

To investigate the association between the pre-operative serum TSH (s-TSH) level and differentiated thyroid carcinoma (DTC) in a mildly iodine-deficient area.

Methods

Patients undergoing surgery for thyroid nodular disease (TND) were included from three tertiary surgical departments. Data were collected from a national thyroid surgery database (THYKIR) and from patient charts. Individuals with overtly coexisting thyroid disorders were excluded for subgroup analyses. Patients were compared with the Danish background population, employing previous data from DanThyr, a study initiated to monitor the iodine fortification program in Denmark.

Results

Nine-hundred ninety-eight patients [cases/controls: 265/733; female/male: 794/204; age (mean ± SD): 51 ± 15 years] were included. S-TSH was significantly higher in the DTC group [median (IQR): 1.3 (0.9–1.9 mIU/L)] compared with the benign TND group [0.9 (0.6–1.5 mIU/L)] (p < 0.0001). The median s-TSH in the background population was similar to that found among DTC patients (p = 1.00), but markedly higher than the s-TSH level in the benign TND group (p < 0.0001). There was no association between s-TSH and DTC disease stage (p = 0.08–0.87).

Conclusions

s-TSH was significantly higher in patients with DTC than in those with benign TND. However, this difference can be explained by abnormally lower s-TSH level in the latter group, probably caused by subtle nodular functional autonomy. Due to the huge overlap and the small difference in median s-TSH between patients with benign and malignant TND, s-TSH is not suitable as a biomarker of DTC in a clinical setting.

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Acknowledgements

The study was supported financially by Aarhus University (fellow ship for K.Z.S.).

Funding

The study was supported by Aarhus University (fellow ship for KZS).

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Authors and Affiliations

  1. Department of Oto-rhino-laryngology (ORL) Head & Neck Surgery, Aarhus University Hospital, Nørrebrogade 44, 8000, Aarhus C, Denmark

    Kristine Zøylner Swan, Jens Faunø Thrane & Sten Schytte

  2. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark

    Kristine Zøylner Swan & Viveque Egsgaard Nielsen

  3. Department of ORL Head & Neck Surgery, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark

    Christian Godballe

  4. Department of ORL Head & Neck Surgery, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark

    Jens Faunø Thrane & Henrik Baymler Pedersen

  5. Department of Endocrinology, Odense University Hospital, Kløvervænget 6, 5000, Odense C, Denmark

    Marie Riis Mortensen & Steen Joop Bonnema

  6. Department of Plastic and Breast surgery, Aarhus University Hospital, Nørrebrogade 44, 8000, Aarhus C, Denmark

    Peer Christiansen

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  1. Kristine Zøylner Swan
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Correspondence to Kristine Zøylner Swan.

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Swan, K.Z., Nielsen, V.E., Godballe, C. et al. Is serum TSH a biomarker of thyroid carcinoma in patients residing in a mildly iodine-deficient area?. Endocrine 61, 308–316 (2018). https://doi.org/10.1007/s12020-018-1637-x

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  • DOI: https://doi.org/10.1007/s12020-018-1637-x

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