Chen Wei1, Li Xiaoyan1*, Dong Pin2, Xie Jin2, Shen Juan3, Zhang Rulin4 and Zhang Lina5
1Department of Otorhinolaryngology, Head and Neck Surgery, Shanghai Children’s Hospital, China
2Department of Otorhinolaryngology, Head and Neck Surgery, Shanghai Jiao Tong University Affiliated the First People's Hospital, China
3Department of Pathology, Shanghai Jiao Tong University Affiliated the First People's Hospital, China
4Departmen of Clinical Laboratory, Shanghai Jiao Tong University Affiliated the First People's Hospital, China
5Department of Medical Statistics, Shanghai Jiao Tong University School of Medicine, China
Objective: To investigate the relationship between Thyroid Stimulating Hormone (TSH), Thyroglobulin (Tg), Thyroglobulin Antibody (TgAb), Thyroid Peroxidase Antibody (TPOAb) and the benign and malignant thyroid nodules before operation.
Methods: A retrospective analysis of serum TSH, Tg, TgAb and TPOAb levels, sex, age, tumor diameter, lymph node metastasis in 1434 patients with thyroid nodules who were admitted to the Otolaryngology Head and Neck Surgery Department of Shanghai First People's Hospital from June 2011 to May 2016 was carried out, and to explore the relationship between TSH, Tg, TgAb and TPOAb and differentiated thyroid carcinoma.
Result: Postoperative pathological diagnosis of benign thyroid nodules in 915 cases, 519 cases of differentiated thyroid carcinoma. There were 426 male patients, including 152 DTC patients and 274 BTN patients; 1008 female patients, including 367 DTC patients and 641 BTN patients. There was no significant difference in the incidence of thyroid cancer between the two groups. The average age of DTC patients (46.925 ± 13.98 years) was less than that of BTN patients (53.936 ± 11.956 years), and the difference was statistically significant (P<0.05). The mean serum TSH level of DTC patients before operation (2.4885 ± 1.5772) uIU/ml was not significantly different from that of BTN patients (2.4586 ± 2.6947) uIU/ml (P=0.79), but the proportion of thyroid cancer increased with the increase of TSH level (even within the reference value range) (P<0.05). Tg level and positive rate of Tg in DTC patients were lower than those in BTN patients (all P<0.05), positive rate of TgAb and positive rate of Tg combined with TgAb were higher than those in BTN patients (all P<0.05), but positive rate of TPOAb was not different between the two groups (P=0.12). Logistic regression analysis showed that the occurrence of DTC was negatively correlated with age (OR=0.96, P<0.0001) and Tg level (OR=0.302, P<0.05), positively correlated with TgAb positive (OR=2.224, P=0.0002), no correlation with sex (OR=1.036, P=0.7817), elevated TSH (OR=1.110, P=0.05549) and positive TPOAb (OR=1.115, P=0.6459).
Conclusion: Elevated serum TSH, decreased Tg, positive TgAb, younger age, and female may be indicators of predicting the risk of differentiated thyroid cancer, but further large-sample prospective trials are needed to confirm this.
Thyroid stimulating hormone; Thyroglobulin; Thyroglobulin antibody; Thyroid peroxidase antibody; Differentiated thyroid carcinoma
Wei C, Xiaoyan L, Pin D, Jin X, Juan S, Rulin Z, et al. Diagnostic Value of Preoperative Serum Levels of TSH, Tg, TgAb and TPOAb in Thyroid Diseases. Clin Surg. 2019; 4: 2428.