The relationship between papillary thyroid carcinoma and preoperative TSH level: A cross-sectional study from Syria

Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, and thyroid stimulating hormone (TSH) is the major growth factor for thyroid cells. It is also an available, inexpensive test and performed routinely while evaluating thyroid nodules. Yet the relationship between TSH levels and PTC is still controversial. Understanding the relationship between preoperative TSH levels and thyroid cancer helps to break new ground of current prevention, diagnosis, and management approaches of thyroid cancer. A cross-sectional retrospective study of patients underwent total thyroidectomy during 2019 at Al-Assad University Hospital, which included 305 individuals. All patients underwent thyroid ultrasonography and laboratory assessment of serum TSH levels prior to surgery, in addition to recording histological features of resected thyroid samples. The malignancy rate was 21.3%, PTC patients had higher TSH values across the entire study even when gender, age and number of thyroid nodules differed. A statistically significant increase in TSH levels was noticed by moving from the benign thyroid nodular disease (BTND) group to papillary thyroid microcarcinoma (PTMC) group, then to thyroid cancer of larger size (TCLS) group (P = .001). A statistically significant relationship was also found between high TSH levels and lymph node metastases (LNM) (P = .008). TSH concentrations were significantly higher in patients with PTC, and higher TSH values were associated with TCLS and LNM.