Journal
AMERICAN JOURNAL OF SURGERY
Volume 220, Issue 3, Pages 634-641Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2020.01.009
Keywords
Differentiated thyroid cancer; Preoperative; Thyroid carcinoma; Thyroid nodules; Thyroid-stimulating hormone
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Funding
- Merck Serono Co., Ltd, China (an affiliate of Merck KGaA Darmstadt, Germany)
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Background: This systematic review and meta-analysis was conducted to determine the value of preoperative thyroid-stimulating hormone (TSH) levels in assessing the risk of differentiated thyroid cancer (DTC) in patients with thyroid nodules. Methods: This meta-analysis included 23,799 subjects (15,406 non-Chinese and 8,393 Chinese) with thyroid nodules. Multivariate and individual adjusted odds ratios (OR) were calculated for a 1 mU/L increase in preoperative TSH levels to determine the risk of malignant DTC. Results: The OR for DTC in relation to preoperative TSH levels was significant in Chinese (1.25 [1.11, 1.40], Z = 3.67, p = 0.0002) and non-Chinese subjects (1.12 [1.03, 1.22], Z = 2.72, p = 0.006). The overall random-effects model indicated that there was a significantly increased risk for DTC in patients with thyroid nodules (OR 1.16 [1.06, 1.27], Z = 3.29, p = 0.007). Conclusions: A significant association between higher TSH levels and risk of DTC was observed in both population groups investigated, with higher ORs for Chinese subjects. (C) 2020 Elsevier Inc. All rights reserved.
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