Study On The Relationship Between Benign And Malignant Thyroid Nodules And Urinary Iodine And Preoperative Serum Thyroid Stimulating Hormone In Qingdao Area

Objective To evaluate the association between preoperative serum thyroid stimulating hormone (TSH) levels and the benign or malignant thyroid nodules.Methods (1) To retrospectively analyzed1499cases of thyroid nodules resected patients(from January2003to June2011) whoes serum TSH level, thyroid B-Doppler ultrasound reports, surgical records, pathological diagnosis reports. According to pathology reports to determine the benign or malignant thyroid nodules, to analysis the different distribution between benign and malignant thyroid nodules in preoperative serum TSH levels.(2) Collect the morning urine on an empty stomach of154cases of surgical resection of the benign or malignant nodules of patients from June2010to June2011, using ammonium persulfate digestion-arsenic cerium catalytic spectrophotometry urine iodine concentration. The statistical analysis of the relationship between the urine iodine concentration and the thyroid nodules.Results (1) The MUI of thyroid benign nodules was331.331ug/L,and the thyroid cancer was466.230ug/L, all in iodine excessive state, both of them have significant differences (P=0.003). The MUI of control group was169.604ug/L, in iodine enough state, there was a great differences between the malignant nodules (or benign nodules) and control group (all P=0.000).(2) The TSH level of differentiated thyroid cancers was higher than the benign nodules(2.179±2.017vs1.259±0.884)uIU/ml, P=0.000.(3) According to the normal range of TSH level (0.27～4.20uIU/ml),we divided into five groups:(0,0.27]uIU/ml group,(0.27,1.58]uIU/ml group,(1.58,2.88] ulU/ml group,(2.88,4.2]uIU/ml group and>4.20uIU/ml group. In every group the DTC accounted for12.10%、17.39%、39.19%、62.5%and94.68%. Following the TSH level, DTC patients proportion to increase gradually,(P=0.000).(4) The serum TSH level and urine iodine of Ⅲ、Ⅳ stage patients with significantly higher than Ⅰ、Ⅱ phase patients (respectively4.132±2.52vs2.543±1.875uIU/ml and1258.821vs298.623ug/L, P=0.000).(5) DTC with lymph node metastasis, the TSH level and urine iodine higher than without lymph node metastasis(0.5±0.4vs0.2±0.5uIU/ml and1584.623vs315.609ug/L, P=0.000).(6) Sand calcification, TSH, urine iodine concentration, Tg-Ab were the risk factors to forecast differentiated thyroid cancer.Conclusion There was a significant correlation between thyroid nodules disease and high iodine concentration, iodine excessive maybe an independent risk factor to predict PTC. Preoperative serum TSH levels is an important indicator to predict thyroid nodules benign or malignant.