title: Serum thyrotropin concentration in children with isolated thyroid nodules.
abstract: OBJECTIVE
  To investigate the correlation between serum thyroid-stimulating hormone (TSH) concentration and nodule nature in pediatric patients with thyroid nodules, with the aim of identifying a marker able to differentiate benign and malignant nodules.
  
  
  METHODS
  This was a retrospective analysis of serum TSH concentrations in a multicentric case series of 125 pediatric patients with benign and malignant thyroid nodules.
  
  
  RESULTS
  Of the 125 patients, 99 had benign thyroid nodules and 26 had differentiated thyroid cancer (24 papillary and 2 follicular). Final diagnosis was based on surgery in 57 cases and on a benign cytology plus clinical follow-up in 68 cases. Serum TSH concentration was significantly higher in patients with thyroid cancer compared with those with benign nodules (3.23 ± 1.59 mU/L vs 1.64 ± 0.99 mU/L; P < .001). Binary logistic regression analysis revealed that serum TSH was the sole predictor of malignancy (P < .001). Dividing the patient cohort into 5 groups based on serum TSH quintiles (TSH cutoffs 0.40, 1.00, 1.50, 1.80, and 2.80 mU/L), we observed that cancer prevalence increased in parallel with serum TSH (P < .001), with respective rates of 0%, 4%, 16%, 32%, and 52% in the 5 quintile groups.
  
  
  CONCLUSIONS
  Because cases with malignant nodules are most likely seen in the upper normal serum TSH range (ie, >2.8 mU/L), serum TSH concentration can serve as a predictor of thyroid cancer in pediatric patients with thyroid nodules and can inform the decision of when to submit patients to further investigation by cytology.
authors: Division of Pediatric Endocrinology, Department of Pediatrics, University of Torino, Torino, Italy. Electronic address: alessandro.mussa@unito.it.
authors: Alessandro
authors: A
authors: Mussa
authors: Maria Carolina
authors: MC
authors: Salerno
authors: Gianni
authors: G
authors: Bona
authors: Malgorzata
authors: M
authors: Wasniewska
authors: Maria
authors: M
authors: Segni
authors: Alessandra
authors: A
authors: Cassio
authors: Maria Cristina
authors: MC
authors: Vigone
authors: Roberto
authors: R
authors: Gastaldi
authors: Lorenzo
authors: L
authors: Iughetti
authors: Arianna
authors: A
authors: Santanera
authors: Donatella
authors: D
authors: Capalbo
authors: Patrizia
authors: P
authors: Matarazzo
authors: Filippo
authors: F
authors: De Luca
authors: Giovanna
authors: G
authors: Weber
authors: Andrea
authors: A
authors: Corrias
mesh_terms: D000293:Adolescent; D044963:Biopsy, Fine-Needle; D015992:Body Mass Index; D049109:Cell Proliferation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D016606:Thyroid Nodule / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D013972:Thyrotropin / Q000097:blood*
chemical_list: D013972:Thyrotropin
keywords: BMI; Body mass index; FNAB; Fine-needle aspiration biopsy; TSH; Thyroid-stimulating hormone