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Am J Surg. 2010 Mar;199(3):294-7; discussion 298. doi: 10.1016/j.amjsurg.2009.08.028.

The utility of preoperative serum thyroid-stimulating hormone level for predicting malignant nodular thyroid disease.

Author information

1
Department of Surgery, MetroHealth Medical Center, 2500 Metrohealth Drive, Cleveland, OH 44109-1998, USA.

Abstract

INTRODUCTION:

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).

METHODS:

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.

RESULTS:

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.

CONCLUSION:

The serum TSH level may be useful in predicting the probability of cancer and optimizing the extent of thyroidectomy in patients with NTD.

PMID:
20226898
DOI:
10.1016/j.amjsurg.2009.08.028
[Indexed for MEDLINE]

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