The role of thyroid stimulating hormone level as a predictive factor for advance stage thyroid carcinoma

https://doi.org/10.19106/JMedSci005104201908

Bambang Udji Djoko Rianto(1*), Anton Sony Wibowo(2), Camelia Herdini(3)

(1) Otorhinolaryngology Head and Neck Surgery Departement, Faculty of Medicine Universitas Gadjah Mada Yogyakarta
(2) Otorhinolaryngology Head and Neck Surgery Departement, Faculty of Medicine Universitas Gadjah Mada Yogyakarta
(3) Otorhinolaryngology Head and Neck Surgery Departement, Faculty of Medicine Universitas Gadjah Mada Yogyakarta
(*) Corresponding Author

Abstract


Thyroid stimulating hormone (TSH) is a cancer growth stimulus factor that have effect on the progression of thyroid carcinoma, common neck head malignancy. This hormonelevel has diagnostic value and can assist in the diagnosis, staging and management of the thyroid carcinoma.This study aimed to investigatethe role of TSH level as a predictor of advance stage thyroid carcinoma. This was case-control study involvingthyroid enlargement subjects who underwent thyroidectomy at Dr. Sardjito General Hospital, Yogyakartafrom 2015 to 2017. Cancer staging examination using AJCC 2102and TSH levels examination were conducted before underwent thyroidectomy.The inclusion criteria for case group were advanced stage(stage III and IV), while for control group wereearly-stage of thyroid carcinoma (stage I and II). The exclusion criteria for both case and control groups were 1) suffering from thyroid hormone disorders requiring therapy before thyroidectomy, 2) receiving thyroid suppression therapy prior to thyroidectomy. Sixty-six post thyroidectomy patients were involved in this study. The patients were divided into case and control groups consisted of 33 patients in each group. Based on receiver operating characteristic curve, the cut of point 1.27 mIU/L for TSH was obtained with sensitivity of 72.7% and specificity of 78.8%. There was statistically significant difference TSH levelsbetween early stage thyroid carcinoma and late stage thyroid carcinoma(p = 0.001;OR: 9.9;95% CI: 3.19-30.15).It can be concluded that TSHlevels ≥ 1.27mIU/L as predictor of advance stage thyroid carcinoma.


Keywords


thyroid stimulating homone; thyroid carcinoma; early stage; advance stage; predictor

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References

1. Le KT, Sawicki MP, Wang MB, Hershman JM, Leung AM. High prevalence of agent orange exposure among thyroid cancer patients in the National VA Healthcare System. Endocr Pract 2016; 22(6):699–702.
https://doi.org/10.4158/EP151108.OR
2. Evans PHR, Montgomery PQ, Gullane PJ. Principles and practice of head and neck surgery and oncology, Second Edition. CRC Press. 2009.
https://doi.org/10.3109/9781439825464
3. Mazzaferri EL, Kirwan RJAJ. Endocrine tumors. essentials of thyroid cancer management, cancer treatment and research. Springer US. 2006; 278–323.
4. Jin J, Machekano R, McHenry CR. The utility of preoperative serum thyroid-stimulating hormone level for predicting malignant nodular thyroid disease. Am J Surg 2010; 199(3):294-8.
https://doi.org/10.1016/j.amjsurg.2009.08.028
5. Weir HK, Thompson TD, Soman A, Miller B, Leadbetter S. The past, present, and future of cancer incidence in the United States: 1975 through 2020. Cancer 2015; 121(11):1827-37.
https://doi.org/10.1002/cncr.29258
6. Haymart MR, Repplinger DJ, Leverson GE, Elson DF, Sippel RS, Jaume JC, et al. Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocrinol Metab 2008; 93(3):809-14.
https://doi.org/10.1210/jc.2007-2215
7. Boelaert K, Horacek J, Holder RL, Watkinson JC, Sheppard MC, Franklyn JA. Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J Clin Mol Endocrino 2006; 91(11):4295-301.
https://doi.org/10.1210/jc.2006-0527
8. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA 2006; 295(18):2164-7.
https://doi.org/10.1001/jama.295.18.2164
9. Gul K, Ozdemir D, Dirikoc A. Are endogenously lower serum thyroid hormones new predictors for thyroid malignancy in addition to higher serum thyrotropin? Endocrine 2010; 37(2):253-60.
https://doi.org/10.1007/s12020-010-9316-6
10. Williams RH, Wilson JD. The Thyroid Gland. Williams Textbook of Endocrinology, 9th ed. Saunders. 1998; 389-402.
11. McLeod DS, Watters KF, Carpenter AD, Ladenson PW, Cooper DS, Ding EL. Thyrotropin and thyroid cancer diagnosis: a systematic review and dose-response meta-analysis. J Clin Mol Endocrinol 2012; 97(8):2682-92.
https://doi.org/10.1210/jc.2012-1083
12. Lee GA, Umesh M. Disorders of the thyroid gland. CURRENT diagnosis & treatment otolaryngology--head and neck surgery, Third Edition, LANGE CURRENT Series, 3th ed. New York: Mcgraw-hill. 2011; 571–591.
13. Morris LGT, Sikora AG, Tosteson TD, Davies L. The increasing incidence of thyroid cancer: the influence of access to care. Thyroid 2013; 23(7):885-91.
http://doi.org/10.1089/thy.2013.0045
14. Yeh MW, Bauer AJ, Bernet VA, Ferris RL, Loevner LA, Mandel SJ, et al. American thyroid association statement on preoperative imaging for thyroid cancer surgery. Thyroid 2015; 25(1):3-14.
https://doi.org/10.1089/thy.2014.0096
15. Association BT. Guidelines for the management of thyroid cancer. 2th ed. London: Royal College of Physicians. 2007.
16. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2006; 16(2):109-42.
https://doi.org/10.1089/thy.2006.16.109
17. McDougall IR. Management of thyroid cancer and related nodular disease. Springer Science & Business Media. 2006.
18. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016; 26(1):1-133.
https://doi.org/10.1089/thy.2015.0020
19. Zhang I, DeMauro-Jablonski S, Ferris RL. Treatment of thyroid neoplasm. bailey’s head and neck surgery: otolaryngology. Wolters Kluwer Health 2014; 2115-29.
20. Custodia GJ, Santisteban P. TSH Signalling and Cancer. Arq Bras Endocrinol Metab 2007; 51(5):654-71.
https://doi.org/10.1038/nrc1836
21. Kondo T, Ezzat S, Asa S. Pathogenetic mechanisms in thyroid follicular-cell neoplasia. Nat Rev Cancer 2006; 6(4):292-306.
https://doi.org/10.1038/nrc1836
22. Boelaert K. The association between serum TSH concentration and thyroid cancer. Endocr Relat Cancer 2009; 16(4):1065-72.
https://doi.org/10.1677/ERC-09-0150
23. Soh EY, Sobhi SA, Wong MG, Meng YG, Siperstein AE, Clark OH, et al. Thyroid-stimulating hormone promotes the secretion of vascular endothelial growth factor in thyroid cancer cell lines. Surgery 1996; 120(6):944-7.
https://doi.org/10.1016/S0039-6060(96)80038-9
24. Moon JH, Ahn S, Seo J, Han JW, Kim KM, Choi SH, et al. The effect of long-term thyroid-stimulating hormone suppressive therapy on the cognitive function of elderly patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab 2014; 99(10):3782-9.
https://doi.org/10.1210/jc.2013-4454
25. Zafon C, Obiols G, Baena JA, Castellví J, Dalama B, Mesa J. Preoperative thyrotropin serum concentrations gradually increase from benign thyroid nodules to papillary thyroid microcarcinomas then to papillary thyroid cancers of larger size. J Thyroid Res 2012; 2012:530721.
https://doi.org/10.1155/2012/530721
26. Beasley MJ. Lymphoma of the thyroid and head and neck. Clin Oncol 2012; 24(5):345-51.
https://doi.org/10.1016/j.clon.2012.02.010



DOI: https://doi.org/10.19106/JMedSci005104201908

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