The Relationship Between TSH Level and Stage of Differentiated Thyroid Carcinoma

ABSTRACT

Objective: The aim of this study was to determine whether thyroid-stimulating hormone (TSH) levels during the diagnosis of patients with differentiated thyroid carcinoma could be used for the prediction of cancer behavior. Material and Methods: The records of 329 patients with differentiated thyroid carcinoma who did not use levothyroxine at the time of diagnosis were reviewed retrospectively. The demographic and clinical characteristics of the cases and serum TSH levels were recorded at the time of diagnosis and statistically analyzed. Results: A total of 329 cases with 322 papillary carcinomas and 7 follicular carcinomas were included in the study. The median age of the participants at the time of diagnosis was 45 (17-76) years. Eighty-three percent of the cases were diagnosed in stage 1, 6.7% in stage 2, 3.3% in stage 3, and 7.0% in stage 4. The median serum TSH level at the time of diagnosis of the cases was 1.34 (0.01- 9.97) mIU/mL. We did not observe any statistically significant relationship between the serum TSH level and the stage of differentiated thyroid carcinoma, although higher serum TSH level was associated with lymph node metastasis and higher risk group in the American Thyroid Association (ATA) classification. Conclusion: The relationship between serum TSH level and thyroid cancer has not been clearly determined, but high TSH levels at the time of diagnosis were found to be associated with lymph node metastasis and medium-high ATA risk score.