title: Lack of association between high serum thyroid-stimulating hormone level and risk of papillary thyroid microcarcinomas.
abstract: BACKGROUND
  High serum thyroid-stimulating hormone (TSH) is associated with thyroid carcinoma in patients with thyroid nodules. However, previous studies suggests that TSH is not involved in the pathogenesis of small thyroid carcinomas. We performed this study to evaluate serum TSH as a malignancy predictor in the assessment of small thyroid nodules.
  
  
  METHODS
  We retrospectively analyzed 3791 patients who underwent thyroidectomy. We classified all patients into 3 to 5 groups by serum TSH or nodule size and analyzed the association of serum TSH and risk of papillary thyroid carcinoma (PTC).
  
  
  RESULTS
  The frequency of PTC increased as serum TSH increased. Serum TSH and older age were associated with the risk of PTC in multivariate analysis (p < .0001). In subgroup analysis, the risk of PTC increased as serum TSH increased with thyroid nodules > 1 cm (p < .05).
  
  
  CONCLUSIONS
  Serum TSH may not be useful for clinical risk assessment of small thyroid nodules.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seo Young
authors.initials: SY
authors.lastname: Sohn
authors.forename: Hye Jeong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Jang
authors.forename: Sun Wook
authors.initials: SW
authors.lastname: Kim
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000097:blood / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D016606:Thyroid Nodule / Q000097:blood / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D013972:Thyrotropin / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D013972:Thyrotropin
keywords: TSH; papillary thyroid carcinoma; risk factors; thyroid neoplasm; thyroid nodule