ECE2018 Guided Posters Thyroid Cancer - Diagnostics & Treatments (12 abstracts)
Association between preoperative thyrotrophin and clinicopathological and aggressive features of papillary thyroid cancer
Abbas Ali Tam 1 , Didem Ozdemir 1 , Cevdet Aydın 2 , Nagihan Bestepe 1 , Serap Ulusoy 2 , Nuran Sungu 3 , Reyhan Ersoy 1 & Bekir Cakir 1
1Department of Endocrinology and Metabolism, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey; 2Department of Surgery, Ataturk Training and Research Hospital, Ankara, Turkey; 3Department of Pathology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey.
Aim: We aimed to investigate the relation between preoperative serum thyrotrophin (TSH) and clinicopathological features in patients with papillary thyroid carcinoma (PTC) and microcarcinoma (PTMC).
Methods: Patients who underwent thyroidectomy and diagnosed to have benign nodular disease or PTC/PTMC in our clinic were evaluated retrospectively. Patients with a previous history of thyroid surgery, patients using antithyroid medications or thyroid hormone and patients with tumors known to be unresponsive to TSH were excluded. Histological variants of PTC were classified as nonaggressive (classical/conventional and follicular variants), aggressive (tall cell, diffuse sclerosing and columnar variants) and other variants.
Results: Data of 1632 patients were analyzed. Histopathological diagnosis was benign in 969 (59.4%) and malignant in 663 (40.6%) patients. Preoperative median serum TSH was significantly higher in malignant compared to benign group (1.41 IU/dl vs 0.98 IU/dl, P<0.001). Malignancy risk increased gradually as going from hyperthyroidism to euthyroidism and hypothyroidism (20, 40.6 and 59.1%, respectively, P<0.05). Serum TSH was lowest in benign nodular disease, higher in PTMC and highest in PTC (P<0.001). This was also true when patients with positive antithyroid peroxidase/antithyroglobulin and with lymphocytic thyroiditis were excluded from the analysis (P<0.001). Serum TSH was higher in patients with bilateral tumor, capsular invasion and lymph node metastasis (LNM) compared to patients with unilateral tumor, without capsule invasion and without LNM, respectively (P=0.036, P=0.002 and P=0.001, respectively). Patients with aggressive variant PTC had higher serum TSH than nonaggressive ones (P<0.05).
Conclusion: Preoperative serum TSH was associated with increased risk of thyroid cancer and LNM regardless of autoimmune thyroid disease. With the present study, for the first time, we showed higher preoperative TSH in aggressive variants of PTC compared to nonaggressive ones.
Volume 56
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Endocrine Abstracts
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