Endocrine Abstracts

Aim: Thyroid cancer comprises the most common endocrine malignancy and a variety of studies have examined the role of TSH as an independent risk factor for the manifestation of differentiated thyroid cancer in otherwise benign thyroid disorders. Objective of the current retrospective study was the assessment of a possible relation between baseline serum TSH and thyroid microcarcinoma in a patient cohort with non-toxic thyroid disorders and without preoperative cytological establishment of thyroid cancer who underwent total thyroidectomy.

Patients and methods: Between 1 January 2005 and 1 March 2010, 186 patients (146 female/40 male) underwent total thyroidectomy because of nodular thyroid disease in our Department. Thyroid specimens were histopathologically examined at the University Pathology Department for the establishment of the final diagnosis of benignity or malignancy. Median values of preoperative serum TSH were estimated in both dignity groups and the results were compared regarding preoperative diagnosis.

Results: Thirty-two patients (17.2%) were diagnosed with microcarcinoma (rate females: males 2.2:1), while 154 patients (82.8%) were free of malignancy. The median value of basal serum TSH was higher in the malignancy group and without statistical significance (1.02 vs 0.80; P value 0.293). Regarding patients with solitary thyroid nodule TSH presented higher in the benignity cohort (1.3 vs 0.83; P value 0.289), whereas in patients with non-toxic multinodular goiter TSH was higher in the malignancy group but marginally without statistical significance compared to the benignity group (1.16 vs 0.75; P value 0.05)

Conclusions: In the present study, basal serum TSH did not feature an independent risk predictor for the development of thyroid microcarcinoma in non-toxic nodular thyroid diseases. A borderline non-significant trend of higher TSH was shown however in non-toxic multinodular goiter harbouring malignancy. Further studies evaluating the role of TSH in thyroid cancer are required.