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Synthesis and Regulation of Thyroid Hormones01:20

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
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Elevated Preoperative TPO Ab Titers Decrease Risk for DTC in a Linear Fashion: A Retrospective Analysis of 1635

Rodis Paparodis1,2, Sarantis Livadas3, Evangelos Karvounis4

  • 1Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences (formerly Medical College of Ohio), University of Toledo, Toledo, OH 43606, USA.

The Journal of Clinical Endocrinology and Metabolism
|July 13, 2023
PubMed
Summary

Higher thyroid peroxidase antibodies (TPO-Abs) titers correlate with a reduced risk of differentiated thyroid cancer (DTC). This study found that increasing TPO-Ab levels offer a linear protective effect against DTC development in patients undergoing thyroidectomy.

Keywords:
screeningthyroid cancerthyroid nodules

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Area of Science:

  • Endocrinology
  • Oncology
  • Immunology

Background:

  • Chronic lymphocytic thyroiditis (Hashimoto thyroiditis) is a known risk factor for differentiated thyroid cancer (DTC).
  • Previous studies suggested thyroid peroxidase antibodies (TPO-Abs) might play a role in DTC risk, but clinical observations suggested otherwise.

Purpose of the Study:

  • To evaluate the relationship between TPO-Abs and DTC in a large, multi-center patient population.
  • To investigate whether TPO-Abs titers influence the risk of developing DTC.

Main Methods:

  • A retrospective analysis of 8461 thyroid surgery cases from the USA and Greece (2000-2021).
  • Data on TPO-Abs titers (measured by chemiluminescence immunoassay) and surgical pathology were collected.
  • TPO-Abs positivity was defined as ≥34 IU/mL; odds ratios (OR) for DTC were calculated.

Main Results:

  • Differentiated thyroid cancer (DTC) was diagnosed in 716 (43.8%) of 1635 patients with available TPO-Abs data.
  • Patients with positive TPO-Abs (TPO+) had a lower frequency of DTC (36.7%) compared to TPO-negative (TPO-) patients (47.3%), with an OR of 0.64 (P < .0001).
  • A significant linear inverse correlation was observed between increasing TPO-Abs titers and DTC risk, with higher titers conferring greater protection.

Conclusions:

  • Elevated TPO-Ab titers are associated with a protective effect against differentiated thyroid cancer (DTC) in patients undergoing thyroidectomy.
  • The protective effect of TPO-Abs against DTC increases linearly with rising antibody titers.