Assessment of Preoperative TSH Serum Level and Thyroid Cancer Occurrence in Patients with AUS/FLUS Thyroid Nodule Diagnosis
Thyroid-stimulating hormone (TSH) is a growth factor associated with the initiation and progression of well-differentiated thyroid cancer (WDTC). Atypia of undetermined significance and follicular lesion of undetermined significance (AUS/FLUS) are the most uncertain cytological diagnoses of thyroid...
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MDPI AG
2022-08-01
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| Online Access: | https://www.mdpi.com/2227-9059/10/8/1916 |
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| author | Krzysztof Kaliszewski Dorota Diakowska Marta Rzeszutko Łukasz Nowak Beata Wojtczak Krzysztof Sutkowski Maksymilian Ludwig Bartłomiej Ludwig Agnieszka Mikuła Maria Greniuk Urszula Tokarczyk Jerzy Rudnicki |
| author_facet | Krzysztof Kaliszewski Dorota Diakowska Marta Rzeszutko Łukasz Nowak Beata Wojtczak Krzysztof Sutkowski Maksymilian Ludwig Bartłomiej Ludwig Agnieszka Mikuła Maria Greniuk Urszula Tokarczyk Jerzy Rudnicki |
| author_sort | Krzysztof Kaliszewski |
| collection | DOAJ |
| description | Thyroid-stimulating hormone (TSH) is a growth factor associated with the initiation and progression of well-differentiated thyroid cancer (WDTC). Atypia of undetermined significance and follicular lesion of undetermined significance (AUS/FLUS) are the most uncertain cytological diagnoses of thyroid nodules. The aim of the study was to determine the association of histopathological diagnosis with preoperative serum TSH levels in patients with AUS/FLUS thyroid nodule diagnosis. Among 5028 individuals with thyroid nodules, 342 (6.8%) with AUS/FLUS diagnoses were analyzed. The frequency of all histopathology diagnoses was assessed for associations with preoperative serum TSH levels. The median TSH concentration was significantly higher in patients with AUS/FLUS diagnosis and histopathology of WDTC than in patients with the same cytology result and histopathology of a benign tumor (<i>p</i> < 0.0001). The diagnostic potential of serum TSH level was determined to evaluate risk of malignancy in patients with thyroid nodules classified into the Bethesda III category. ROC analysis showed the TSH concentration at a cutoff point of 2.5 mIU/L to be an acceptable prognostic factor for WDTC. For this optimal cutoff point, the AUC was 0.877, the sensitivity was 0.830, and the specificity was 0.902. Preoperative serum TSH levels in patients with AUS/FLUS thyroid tumor diagnosis should be taken into consideration in the decision-making process and clinical management. |
| first_indexed | 2024-03-09T04:39:54Z |
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| id | doaj.art-45140329c3814c4f9faf61a3ce5d5f1c |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-09T04:39:54Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-45140329c3814c4f9faf61a3ce5d5f1c2023-12-03T13:21:46ZengMDPI AGBiomedicines2227-90592022-08-01108191610.3390/biomedicines10081916Assessment of Preoperative TSH Serum Level and Thyroid Cancer Occurrence in Patients with AUS/FLUS Thyroid Nodule DiagnosisKrzysztof Kaliszewski0Dorota Diakowska1Marta Rzeszutko2Łukasz Nowak3Beata Wojtczak4Krzysztof Sutkowski5Maksymilian Ludwig6Bartłomiej Ludwig7Agnieszka Mikuła8Maria Greniuk9Urszula Tokarczyk10Jerzy Rudnicki11Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, PolandDepartment of Basic Science, Faculty of Health Science, Wroclaw Medical University, Bartel Street 5, 51-618 Wroclaw, PolandDepartment of Pathomorphology, Wroclaw Medical University, Marcinkowski Street 1, 50-368 Wroclaw, PolandDepartment of Urology and Urological Oncology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, PolandDepartment of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, PolandDepartment of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, PolandDepartment of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, PolandDepartment of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, PolandDepartment of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, PolandDepartment of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, PolandDepartment of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, PolandDepartment of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, PolandThyroid-stimulating hormone (TSH) is a growth factor associated with the initiation and progression of well-differentiated thyroid cancer (WDTC). Atypia of undetermined significance and follicular lesion of undetermined significance (AUS/FLUS) are the most uncertain cytological diagnoses of thyroid nodules. The aim of the study was to determine the association of histopathological diagnosis with preoperative serum TSH levels in patients with AUS/FLUS thyroid nodule diagnosis. Among 5028 individuals with thyroid nodules, 342 (6.8%) with AUS/FLUS diagnoses were analyzed. The frequency of all histopathology diagnoses was assessed for associations with preoperative serum TSH levels. The median TSH concentration was significantly higher in patients with AUS/FLUS diagnosis and histopathology of WDTC than in patients with the same cytology result and histopathology of a benign tumor (<i>p</i> < 0.0001). The diagnostic potential of serum TSH level was determined to evaluate risk of malignancy in patients with thyroid nodules classified into the Bethesda III category. ROC analysis showed the TSH concentration at a cutoff point of 2.5 mIU/L to be an acceptable prognostic factor for WDTC. For this optimal cutoff point, the AUC was 0.877, the sensitivity was 0.830, and the specificity was 0.902. Preoperative serum TSH levels in patients with AUS/FLUS thyroid tumor diagnosis should be taken into consideration in the decision-making process and clinical management.https://www.mdpi.com/2227-9059/10/8/1916thyroid-stimulating hormoneTSHatypia of undetermined significancefollicular lesion of undetermined significanceAUS/FLUSthyroid cancer |
| spellingShingle | Krzysztof Kaliszewski Dorota Diakowska Marta Rzeszutko Łukasz Nowak Beata Wojtczak Krzysztof Sutkowski Maksymilian Ludwig Bartłomiej Ludwig Agnieszka Mikuła Maria Greniuk Urszula Tokarczyk Jerzy Rudnicki Assessment of Preoperative TSH Serum Level and Thyroid Cancer Occurrence in Patients with AUS/FLUS Thyroid Nodule Diagnosis Biomedicines thyroid-stimulating hormone TSH atypia of undetermined significance follicular lesion of undetermined significance AUS/FLUS thyroid cancer |
| title | Assessment of Preoperative TSH Serum Level and Thyroid Cancer Occurrence in Patients with AUS/FLUS Thyroid Nodule Diagnosis |
| title_full | Assessment of Preoperative TSH Serum Level and Thyroid Cancer Occurrence in Patients with AUS/FLUS Thyroid Nodule Diagnosis |
| title_fullStr | Assessment of Preoperative TSH Serum Level and Thyroid Cancer Occurrence in Patients with AUS/FLUS Thyroid Nodule Diagnosis |
| title_full_unstemmed | Assessment of Preoperative TSH Serum Level and Thyroid Cancer Occurrence in Patients with AUS/FLUS Thyroid Nodule Diagnosis |
| title_short | Assessment of Preoperative TSH Serum Level and Thyroid Cancer Occurrence in Patients with AUS/FLUS Thyroid Nodule Diagnosis |
| title_sort | assessment of preoperative tsh serum level and thyroid cancer occurrence in patients with aus flus thyroid nodule diagnosis |
| topic | thyroid-stimulating hormone TSH atypia of undetermined significance follicular lesion of undetermined significance AUS/FLUS thyroid cancer |
| url | https://www.mdpi.com/2227-9059/10/8/1916 |
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