Serum thyrotropin concentration in children with isolated thyroid nodules

Area of Science:

• Pediatric Endocrinology
• Oncology
• Thyroidology

Background:

• Thyroid nodules are common in children, with a higher malignancy rate compared to adults.
• Differentiating benign from malignant thyroid nodules in pediatric patients is crucial for appropriate management.

Purpose of the Study:

• To determine if serum thyroid-stimulating hormone (TSH) concentration can predict malignancy in pediatric thyroid nodules.
• To identify TSH as a potential biomarker for differentiating benign from malignant thyroid nodules in children.

Main Methods:

• Retrospective analysis of serum TSH levels in 125 pediatric patients with thyroid nodules.
• Comparison of TSH concentrations between patients with benign nodules and differentiated thyroid cancer.
• Logistic regression analysis to assess TSH as a predictor of malignancy.

Main Results:

• Serum TSH was significantly higher in pediatric patients with thyroid cancer (3.23 ± 1.59 mU/L) compared to those with benign nodules (1.64 ± 0.99 mU/L).
• TSH was the sole predictor of malignancy (P < .001).
• Cancer prevalence increased with TSH quintiles, reaching 52% in the highest quintile (>2.8 mU/L).

Conclusions:

• Serum TSH concentration can serve as a predictor of thyroid cancer in pediatric patients with thyroid nodules.
• Higher TSH levels, particularly in the upper normal range (>2.8 mU/L), are associated with an increased likelihood of malignancy.
• TSH levels can inform decisions regarding further investigation, such as fine-needle aspiration cytology.