Study On The Relationship Between Serum TSH Level And The Nature Of Thyroid Nodules

ObjectiveTo investigate the relationship between serum level of TSH and thyroid tumorswith benign or malignant characteristic.MeterialsA retrospective analysis of1132cases of thyroid nodules with thyroid surgerywas performed, which included serum level of TSH, surgical records,pathologicalreports and other clinical data. The patients were divided into five groups accordingto the patient’s TSH levels for statistical analysis.947cases were included in the finalof the study, in which patients with nodular goiter740cases, including579cases offemale,161cases of male, average age of (49.87±12.80) years old; DTC patientswith207cases, including144cases of female,63cases of males, average age of(44.29±13.10) years old.MethodsA retrospective analysis of1132cases of thyroid tumors in patients with medicalmeterials, excluding the effect of human factors in serum TSH levels. collecting thepatient files, including general information, preoperative thyroid function test results[including FT3, FT4, TSH], thyroid ultrasound, postoperative pathology report(pathological type), surgical records (lymph node metastasis or not)and so on.according to the pathological report,the patients were divided into nodular goiter andDTC groups. The resulting data were put into Excel database for statistical analysisimpressing on SPSS13.0statistical software, measurement data were expressed by mean±standard deviation, normal distribution of the T-test, such as the comparisonof the age between the two groups.On the contrary, such as TSH levels, after takingthe common logarithm of the two groups were compared with t-test. Aftertransformed were not the normal distribution,were compared by rank sum test; therates were Compared with2test; Correlation Analysis of measurement data usedSpearmen correlation analysis; All with P <0.05was Statistically significantdifference.ResultsThe preoperative serum TSH levels in patients with differentiated thyroid cancerwere significantly higher than the patients with nodular goiter [(2.92±2.62) mIU/Lvs (1.67±1.34) mIU/L, P <0.01]. and with the serum TSH levels increased, The riskof thyroid cancer became higher(P <0.01). The group of TSH level lower than0.34mIU/L, the incidence of thyroid cancer was5.1%, while the incidence rate was8.5%,21.0%,32.0%,57.9%respectively in the group of serum level of0.34~1.0mIU/L,1.0~2.0mIU/L,2.0~5.6mIU/L,>5.6mIU/L group. In addition, TSHlevels and tumor size were positive correlated.ConclusionThis study demonstrated that, The average serum level of TSH in DTC groups ishigher than that in the nodular goiter groups.And with the serum TSH levelsincreased, The risk of thyroid cancer became higher.The larger the tumor is, thehigher the level of TSH. Also the incidence of nodules Calcify in higher TSH levelsgroup was significantly higher than those in low TSH levels.Therefore, we speculatethat high TSH level can promote the occurrence and development of Thyroidtumors,may be used as a predictor of thyroid cancer. The clinical significance of thisstudy lies in that through its general clinical data, TSH levels, malignant tumordiameter to make a preliminary judgment on patients with thyroid nodules.Those whoare highly suspicious of thyroid cancer will need fine needle aspiration for furtherexamination or surgery. If fine-needle aspiration examination or rapid intraoperative pathology report revealed DTC, accompanied by a high TSH level, and they shouldbe highly suspected later tumor stage or small lesions which are difficult to find.Weshould carefully explore the Cervical lymph nodes and thyroid nearby tissue.It maybe necessary to expand the scope of surgical resection, and strive to completeresection of tumor, to reduce the risk of cancer recurrence. For fine-needle aspirationbiopsy found no cancer cells but also accompanied by high levels of TSH in patientsshould be closely followed up or re-puncture.