Lower levels of TSH are associated with a lower risk of papillary thyroid cancer in patients with thyroid nodular disease: thyroid autonomy may play a protective role

被引：174

作者：

Fiore, E. ^{[1
]}

Rago, T. ^{[1
]}

Provenzale, M. A. ^{[1
]}

Scutari, M. ^{[1
]}

Ugolini, C. ^{[2
]}

Basolo, F. ^{[2
]}

Di Coscio, G. ^{[3
]}

Berti, P. ^{[4
]}

Grasso, L. ^{[1
]}

Elisei, R. ^{[1
]}

Pinchera, A. ^{[1
]}

Vitti, P. ^{[1
]}

机构：

[1] Univ Pisa, Dept Endocrinol, I-56100 Pisa, Italy

[2] Univ Pisa, Sect Pathol, I-56100 Pisa, Italy

[3] Univ Pisa, Sect Cytopathol, I-56100 Pisa, Italy

[4] Univ Pisa, Dept Surg, I-56100 Pisa, Italy

来源：

关键词：

SERUM THYROTROPIN CONCENTRATION; UNITED-STATES POPULATION; NATIONAL-HEALTH; CARCINOMA; THERAPY; MALIGNANCY; ANTIBODIES; MANAGEMENT; PREDICTOR; GOITER;

D O I：

10.1677/ERC-09-0036

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Higher TSH values, even within normal ranges, have been associated with a greater risk of thyroid malignancy The relationship between TSH and papillary thyroid cancer (PTC) has been analyzed in 10 178 patients submitted to fine needle aspiration of thyroid nodules with a cytology of PTC (n=497) or benign thyroid nodular disease (BTND, n=9681). In 942 patients, submitted to surgery (521 from BTND and 421 from PTC), the histological diagnosis confirmed an elevated specificity (99.6%) and sensitivity (98.1%) of cytology. TSH levels were significantly higher in PTC than in BTND both in the cytological and histological series and also in patients with a clinical diagnosis of multinodular goiter (MNG) and single/isolate nodule (S/I). A significant age-dependent development of thyroid autonomy (TSH <0.4 mu U/ml) was observed in patients with benign thyroid disease, but not in those with PTC, diagnosed both on cytology and histology In patients with MNG, the frequency of thyroid autonomy was higher and the risk of PTC was lower compared to those with S/I In all patients, the presence of thyroid auto-antibodies (TAb) was associated with a significant increase of TSH However, both in TAb positive and TAb negative patients TSH levels were significantly higher in PTC than in BTND Our data confirm a direct relationship between TSH levels and risk of PTC in patients with nodular thyroid diseases. Thyroid autonomy conceivably protects against the risk of PTC, while thyroid autoimmunity does not play a significant role Endocrine-Related Cancer (2009) 16 1251-1260

引用

页码：1251 / 1260

页数：10

共 35 条

[31]

Suen KC, 1996, DIAGN CYTOPATHOL, V15, P84, DOI 10.1002/(SICI)1097-0339(199607)15:1<84::AID-DC18>3.0.CO

[32]

2-8

[33] Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: Implications for the prevalence of subclinical hypothyroidism [J].