Endocrine Abstracts

Background: Plasma TSH is a fundamental marker of thyroid function. The TSH level might be different depending on nodule’s type. Recent studies have shown a relationship between plasma TSH levels and thyroid nodules malignancy. The aim of this study was to compare the TSH level between two groups of subjects who had undergone total thyroidectomy, one group whose final histology was benign and one group who had a malignant histology.

Materials and methods: It was a retrospective study including 250 patients followed in Endocrinology department of bn Rochd University Hospital of Casablanca between 2012 and 2017, for nodule or multinodular goitre, having undergone surgery. Two groups of patients were compared according to the level of TSH: 1/3 higher, 1/3 medium and 1/3 lower. Different variables were studied such as age, gender, family history of thyroid disease. Statistical analysis performed by the software SPSS.16.

Results: Mean age of the patients was 41 years (18-71 years), with a female predominance (92%). Familial thyropathy was present in 32% of cases. Surgical indicated was in front of the nodule size in 46% of the cases, the toxic character (23%) and the suspicion of malignancy in 25% of the cases. All patients were preoperatively on euthyroidism. Histology was benign in 68% of cases and malignant in 32% of cases. There was no significant difference between the two groups in terms of age, gender, family history of thyroid disease, or thyroid autoimmunity. Subjects whose final histology was malignant had a mean level of TSH significantly higher than subjects with benign disease (2.98 mU/l versus 0.96mU/l, P=0.003). Cancer risk was significantly greater when TSH was in the upper tertile of normal range (P<0.001)

Conclusion: These data confirm a higher level of TSH values in subjects with thyroid cancer. However, it seems difficult to define a threshold that would allow to know preoperatively if the nodule is benign or malignant.