ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P802

Serum thyrotropin concentration as a biochemical predictor of thyroid malignancy in patients presenting with thyroid nodules

Stergios Polyzos1, Marina Kita1, Zoe Efstathiadou1, Pavlos Poulakos1, Aristidis Slavakis2, Danae Sofianou2, Nikolaos Flaris3, Maria Leontsini3, Anargyros Kourtis1 & Avraam Avramidis1


1Department of Endocrinology, Hippokratio General Hospital, Thessaloniki, Greece; 2Department of Microbiology, Hippokratio General Hospital, Thessaloniki, Greece; 3Department of Pathology, Hippokratio General Hospital, Thessaloniki, Greece.


Background: Fine-needle aspiration biopsy is the ‘gold standard’ in the preoperative management of thyroid nodules.

Aim: The aim of this study was to investigate whether serum TSH is a predictor of thyroid malignancy in patients presenting with thyroid nodules.

Subjects and methods: About 565 patients without overt thyroid dysfunction, who presented with palpable thyroid nodule(s) between 1988 and 2004 and underwent at least one FNAB, were retrospectively evaluated.

Results: The final diagnostic outcome was established after surgery (n=122) or after a minimum of one-year clinical follow-up period. Higher rates of malignancy were observed in patients with serum TSH in the upper tertile of the normal range (P=0.026). Binary logistic regression analysis revealed significantly increased adjusted odds ratios for the diagnosis of malignancy in patients with serum TSH 1.5–4.0 mIU/l compared to those with either TSH 0.4–0.8 mIU/l (P=0.005) or TSH 0.9–1.4 mIU/l (P=0.007).

Conclusions: The risk of malignancy in thyroid nodules increases in parallel with TSH concentrations within the normal range. TSH concentration at presentation is an independent predictor of thyroid malignancy.