ERKAN SOMUNCU, NEZİHE BERRİN DODUR ÖNALAN
Comprehensive Medicine - 2023;15(2):102-106
INTRODUCTION: Although thyroid-stimulating hormone (TSH) is known to induce thyroid malignancies, the relationship between pre-operative TSH and patho- logical findings has not been thoroughly evaluated. This study aimed to assess the relationship between pre-operative TSH levels and pathological findings. METHODS: The records of 156 patients (135 women and 21 men) operated for papillary thyroid cancer (PTC) between January 2017 and June 2020 were retrospectively reviewed and divided according to TSH level 2.5 mIU/L above (50 patients) and below (106 patients). The relationship between pre-oper- ative fine-needle aspiration biopsy (FNAB) result, pathological findings, tumor diameter, multicentricity, lymphovascular invasion, extrathyroidal extension, capsule invasion, and neck (central, lateral) metastasis were compared for pre-operative TSH levels. Results: There was no significant difference between pre-operative TSH level and lymphovascular invasion, extrathyroidal extension, central and lateral lymph node metastasis, primary tumor size, and multifocality. However, TSH levels were found to be significant above 2.5 mIU/L in patients with capsule invasion positivity (p=0.007). TSH levels were significantly lower in our patients with malignant or suspected FNAB (p=0.015). DISCUSSION AND CONCLUSION: Although pre-operative high TSH levels tend to be more common malignant in the literature, malignancy and suspected FNAB results are ob- tained in low TSH levels. TSH level should be considered as an independent factor in preoperative diagnosis, and thyroid malignancies should be suspected in cases with a TSH level below 2.5 mIU/L.
