Endocrine Abstracts

Introduction: Nodular goiter is clinically recognizable restricted structure changes of the thyroid gland. FNA is the first line diagnostic test for an enlarged thyroid gland. TSH is known as a thyroid growth factor, but the pathogenic role of this hormone in thyroid oncogenesis is unclear.

Objective: The aim of this study is to analyze the relationship between elevated serum TSH concentrations and thyroid malignancies in patients with nodular thyroid goiter.

Material and Methods: We retrospectively reviewed the 637 reports of thyroid FNA cytology of samples obtained by puncture of patients with nodular thyroid goiter, at Department of thyroid gland, Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia in the period from October 2007. by January 2010. year. We analyzed the relationship between findings of cytopathological diagnostic categories and serum concentrations of TSH. The data were statistically tested using Kruskal Wallis test of differences using the computer program SPSS 12.0 software package.

Results: Of total 637 patients 3.45% (22/637) had a malignant, and 4.87% patients (31/637) cytopathological indeterminate findings. 91.52% (583/637) patients were with benign findings, and only one puncture failed. The average value of TSH in a group of patients with a diagnosis of malignancy was 9.83±17.48 mmol/l with a median 3.31 mmol/l. In all three diagnostic categories (benign, malignant and unspecified) most patients are with the normal concentrations of serum TSH, but there is a relatively large proportion of 27.3% (6/22) of patients with malignant cytopathological findings in the group of patients with elevated TSH concentration. Statistically significant differences between diagnostic categories by group TSH values(P=0.017).

Conclusion: It is concluded that the risk of developing thyroid malignancy increases in patients with elevated serum TSH concentrations. TSH should be used as an additional diagnostic tool in identifying high-risk patients who require further investigation and / or surgical treatment.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector

Keywords: nodular goiter, thyrotropin, fine needle aspiration