Preoperative Serum Thyrotropinlevels And The Risk Of Differentiated Thyroid Cancer

Objectives:The aim was to study the relationship between preoperative serum thyrotropin(TSH) levels and the risk of differentiated thyroid cancer (DTC).Methods:(1)Retrospective analysis4442patients who underwent surgery on thyroid andhad definite pathological diagnosis between January2012to December2013in Shanghairuijinhospital.We studied their clinical datas and surgical pathology reports, and dividedthem into malignant lesion and benign lesion groups,analysis the differences inage,andgender composition.（2）Finally2400patients were included according to theexclusion criteria,andwere dividedinto differentiated thyroid cancer (DTC)lesion andbenign lesion groups,and their preoperative TSH,TGAb and TPOAb levels wererecorded,comparison the differences of serum TSH levels and TGAb, TPOAbstatus.Results:(1)Finaly2051patients (46.2%) were detected in benign lesion,whereas2391cases (53.8%) were present in malignancy.Mean ages of the patients with malignancywere younger than those without malignancy[（44.76±12.39）vs （49.79±12.43）yr,P<0.0001].There were differences in DTC morbidity according the age（[21-45yr）group＞（≤20yr）group＞（46-60yr）group＞（>60yr）group（P＜0.0001）]。Men are moretend to be DTC than women[56.7%vs52.8%,P=0.022].(2)The mean preoperativeserumTSH concentration in malignant patients was1.8816±2.3297uIU/ml,which is higher thanthose cases with benign lesions was1.7564±3.5367uIU/ml(P<0.0001).According to the serum TSH level we divided the patients into5groups from low to high,and the incidence of DTC is increased as TSH levels rise[38.8%vs48%vs57.3%vs62.8%vs66.7%,P<0.0001].The positive rate of TGAb and TPOAbare higher in DTCgroupthan those in benign lesion group.[(39.6%vs26.0%)，(27.3%vs15.7%)，P<0.0001].But there were no correlation between lymphatic metastasis and TSHlevels.Conclusion:Although thyroid diseases are more incidencein women, but men are more tend to be DTC than women.The preoperative TSH level is associated with DTCattack,andthe incidence of DTC is increased as TSH levels rise.The positive rate of thyroidautoantibodysare higher in DTCgroupthan benign lesion group.