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The Effect of Thyroid-Stimulating Hormone on Tumor Size in Differentiated Thyroid Carcinoma

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Abstract

We evaluated the correlation between serum thyroid-stimulating hormone (TSH) levels and tumor size and other invasiveness parameters of tumor in patients with differentiated thyroid carcinoma (DTC). Several clinical studies have reported that TSH may also have a role as a regulator of the development and function of the thyroid gland. It is currently not clear whether TSH is involved in the existence of thyroid cancer or progression of thyroid cancer or both. Patients with DTC who underwent thyroid surgery between 2003 and 2008 were included this study. Preoperative serum T3, T4, and TSH levels were compared with the size and invasiveness of cancer, retrospectively. DTC was observed in 110 patients over the 5-year period. Seventy-seven (70 %) of them were euthyroid and classified as the “normal-TSH group” (NTG), and 33 (30 %) have an overt or subclinical hyperthyroidism, classified as the “low-TSH group” (LTG). The mean tumor diameter in the LTG was found to be 8.91 ± 8.03 mm; however, it was found to be 18.19 ± 16.24 mm in the NTG. There were significantly differences among the groups related to the diameter of tumor (p = 0.001). Microcarcinoma was determined in 36 patients (46.8 %) in the NTG and 23 patients (69.7 %) in the LTG (p = 0.027). Although there were no significant differences, tumor capsule invasion (33.8 vs. 18.2 %, p = 0.099) and lymphovascular invasion (16.9 vs. 6.1 %, p = 0.130) rates were higher in the NTG. These findings suggest that TSH has effects on growing and proliferation of not only normal thyroid cells but also cancer cells in DTC. This study revealed that serum TSH level can be explored as an important factor that affects the size and invasiveness of tumor in DTC.

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References

  1. Pathak KA, Leslie WD, Klonisch TC, Nason RW (2013) The changing face of thyroid cancer in a population-based cohort. Cancer Med 2(4):537–44

    Article  PubMed  Google Scholar 

  2. Canadian Cancer Society’s Steering Committee on Cancer Statistics (2012) Pp 7–60 in Canadian cancer statistics. 2012. Canadian Cancer Society, Toronto, ON

  3. Kim D, Park JW (2013) Clinical implications of preoperative thyrotropin serum concentrations in patients who underwent thyroidectomy for nonfunctioning nodule(s). J Korean Surg Soc 85(1):15–9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Shi L, Li Y et al (2012) Usefulness of serum thyrotropin for risk prediction of differentiated thyroid cancers does not apply to microcarcinomas: result os 1,870 Chinese patients with thyroid nodules. Endocr J 59(11):973–80

    Article  PubMed  Google Scholar 

  5. Zafon C, Obiols G, Baena JA, Castellvi J, Dalama B, Mesa J (2012) Preoperative thyrotropin serum concentrations gradually increase from benign thyroid nodules to papillary thyroid microcarcinomas then to papillary thyroid cancers of larger size. J Thyroid Res. doi:10.1155/2012/530721

  6. Zhu C, Zheng T (2009) A birth cohort analysis of the incidence of papillary thyroid cancer in the United States, 1973-2004. Thyroid 19:1061–6

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cooper DS, Doherty GM (2009) American Thyroid Association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer: revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214

    Article  PubMed  Google Scholar 

  8. Malcolm H, Wheeler MD (1998) Invited commentary prevalence of thyroid cancer in hyperthyroid patients treated by surgery. World J Surg 22:473–478

    Article  Google Scholar 

  9. Goretzki PE, Koob R, Koller T, Simon R, Branscheid D, Clark OH, Röher HD (1986) The effect of thyrotropin and cAMP on DNA synthesis and cell growth of human thyrocytes in monolayer culture. Surgery 100(6):1053–61

    CAS  PubMed  Google Scholar 

  10. Zaballos MA, Santisteban P (2013) FOXO1 controls thyroid cell proliferation in response to TSH and IGF-I and is involved in thyroid tumorigenesis. Mol Endocrinol 27(1):50–62

    Article  CAS  PubMed  Google Scholar 

  11. Boelaert K (2009) The association between serum TSH concentration and thyroid cancer. Endocr-Relat Cancer 16(4):1065–72

    Article  CAS  PubMed  Google Scholar 

  12. Hancock BW, Bing RF, Dirmikis SM, Munro DS, Neal FE (1977) Thyroid carcinoma and concurrent hyperthyroidism. Cancer 39:298–302

    Article  CAS  PubMed  Google Scholar 

  13. Boelaert K, Horacek J, Holder RL, Watkinson JC, Sheppard MC, Franklyn JA (2006) Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J Clin Endocrinol Metab 91(11):4295–4301

    Article  CAS  PubMed  Google Scholar 

  14. Franco AT, Malaguarnera R et al (2011) Thyrotrophin receptor signaling dependence of Braf-induced thyroid tumor initiation in mice. Proc Natl Acad Sci 108:1615–20

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Haymart MR, Repplinger DJ et al (2008) Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocrinol Metab 93:809–14

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Gerschpacher M, Göbl C et al (2010) Thyrotropin serum concentrations in patients with papillary thyroid microcancers. Thyroid 20:389–92

    Article  CAS  PubMed  Google Scholar 

  17. Kamer E, Ünalp HR (2011) Incidental papillary microcarcinoma of thyroid. Endocrinolojide Diyalog 8(3):116–9

    Google Scholar 

  18. Davies L, Welch HG (2006) Increasing incidence of thyroid cancer in the United States, 1973-2002. J Am Med Assoc 295(18):2164–7

    Article  CAS  Google Scholar 

  19. Leenhardt L, Grosclaude P (2004) Increased incidence of thyroid carcinoma in France: a true epidemic or thyroid nodule management effects? Report from the french thyroid cancer committee. Thyroid 14(12):1056–60

    Article  PubMed  Google Scholar 

  20. Gülben K, Berberoğlu U (2008) Incidental papillary microcarcinoma of the thyroid factors affecting lymph node metastasis. Langenbeck's Arch Surg 393:25–29

    Article  Google Scholar 

  21. Lloyd R, De Lellis R (2004) World Health Organization classification of tumors: pathology and genetics of tumors of the endocrine organs. IARC Press, Lyon

    Google Scholar 

  22. Noguchi S, Yamashita H (2008) Papillary microcarcinoma. World J Surg 32(5):747–53

    Article  PubMed  PubMed Central  Google Scholar 

  23. Fiore E, Rago T et al (2009) Lower levels of TSH are associated to a lower risk of papillary thyroid cancer in patients with thyroid nodular disease: thyroid autonomy may play a protective role. Endocr Relat Cancer 16:1251–60

    Article  CAS  PubMed  Google Scholar 

  24. Fiore E, Rago T et al (2010) l-Thyroxine treated patients with nodular goiter have lower serum TSH and lower frequency of papillary thyroid cancer: results of a cross-sectional study on 27,914 patients. Endocr Relat Cancer 17:231–9

    Article  CAS  PubMed  Google Scholar 

  25. Jin J, Machekano R, McHenry CR (2010) The utility of preoperative serum thyroid-stimulating hormone level for predicting malignant nodular thyroid disease. Am J Surg 199(3):294–8

    Article  CAS  PubMed  Google Scholar 

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Conflict of Interest

İbrahim Ali Özemir, MD and other coauthors declare no conflict of interest.

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Authors and Affiliations

  1. Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey

    I. A. Ozemir, B. Gurbuz, B. Bayraktar, S. Aslan, H. Yalman, R. Yigitbasi & O. Alimoglu

  2. Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey

    A. Başkent

  3. Küçüksu Mah., Asma Sok, Eston Kandilli Evleri Sitesi, A-12 Blok, Kandilli, Üsküdar, 34684, Istanbul, Turkey

    I. A. Ozemir

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  1. I. A. Ozemir
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  2. B. Gurbuz
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  3. B. Bayraktar
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  4. S. Aslan
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  5. A. Başkent
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  6. H. Yalman
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  7. R. Yigitbasi
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  8. O. Alimoglu
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Correspondence to I. A. Ozemir.

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Ozemir, I.A., Gurbuz, B., Bayraktar, B. et al. The Effect of Thyroid-Stimulating Hormone on Tumor Size in Differentiated Thyroid Carcinoma. Indian J Surg 77 (Suppl 3), 967–970 (2015). https://doi.org/10.1007/s12262-014-1084-8

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  • DOI: https://doi.org/10.1007/s12262-014-1084-8

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