Higher serum TSH in thyroid cancer patients occurs independent of age and correlates with extrathyroidal extension.
Higher serum TSH in thyroid cancer patients occurs independent of age and correlates with extrathyroidal extension.
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DOI：
10.1111/j.1365-2265.2008.03489.x
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发表时间：
2009-09
影响因子：
3.2
通讯作者：
Chen H
中科院分区：
文献类型：
--
作者：
Haymart MR;Glinberg SL;Liu J;Sippel RS;Jaume JC;Chen H
先前的研究表明，较高的血清 TSH 与甲状腺癌发病率和晚期疾病的增加有关。在健康成年人群中，平均 TSH 随着年龄的增长而增加。由于年龄超过 45 岁是甲状腺癌的已知预后指标，因此了解甲状腺癌患者 TSH 升高是否与年龄无关非常重要。确定较高的 TSH、癌症和年龄之间的关系。一项回顾性队列研究。 1994年5月至2007年12月期间，同一机构共有1361名患者接受了甲状腺手术。在这些患者中，954 例有病理数据、术前 TSH 和完整的手术史。分析了与年龄和 TSH 相关的数据。无论年龄 < 45 岁或≥ 45 岁，癌症患者的平均 TSH 均显着较高（分别为 P = 0·046 和 P = 0·027）。当检查<20岁、20-44岁、45-59岁和≥60岁的年龄组时，平均TSH有随年龄增加的趋势。尽管良性亚组有所增加，但癌症患者的平均 TSH 始终高于非癌症患者。多变量分析显示，较高的 TSH 与癌症（P = 0·039）和桥本甲状腺炎的病理特征（P = 0·001）独立相关，但与年龄无关（P = 0·557）。在与不良预后相关的高危特征的多变量分析中，较高的 TSH 与甲状腺外扩散之间存在显着相关性 (P = 0·002)，而与年龄、肿瘤大小 > 4 cm 和远处转移之间没有明确的关系。与年龄无关，甲状腺癌的发病率与较高的 TSH 相关。较高的 TSH 与疾病的甲状腺外扩展有关。
It has previously been shown that higher serum TSH is associated with increased thyroid cancer incidence and advanced-stage disease. In the healthy adult population, mean TSH increases with age. As age over 45 years is a known prognostic indicator for thyroid cancer, it is important to know whether higher TSH in patients with thyroid cancer occurs independent of age. To determine the relationship between higher TSH, cancer and age. A retrospective cohort study. A total of 1361 patients underwent thyroid surgery between May 1994 and December 2007 at a single institution. Of these patients, 954 had pathological data, pre-operative TSH and complete surgical history available. Data were analysed in relation to age and TSH. Mean TSH was significantly higher in cancer patients regardless of age < 45 years or ≥ 45 years (P = 0·046 and P = 0·027, respectively). When examining age groups < 20, 20–44, 45–59 and ≥ 60 years, there was a trend of rising mean TSH with age. Despite the rise in the benign subgroups, mean TSH was consistently higher in those with cancer vs. those without. On multivariate analysis, higher TSH was independently associated with cancer (P = 0·039) and pathological features of Hashimoto’s thyroiditis (P=0·001) but not with age (P = 0·557). On multivariate analysis of high-risk features associated with poor prognosis, there was a significant association between higher TSH and extrathyroidal extension (P = 0·002), whereas there was no clear relationship with age, tumour size > 4 cm, and distant metastases. Independent of age, thyroid cancer incidence correlates with higher TSH. Higher TSH is associated with extrathyroidal extension of disease.