Document Detail


L-thyroxine-treated patients with nodular goiter have lower serum TSH and lower frequency of papillary thyroid cancer: results of a cross-sectional study on 27 914 patients.
MedLine Citation:
PMID:  20167722     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The risk of papillary thyroid cancer (PTC) is related to serum TSH, and the development of thyroid autonomy by reducing TSH levels decreases the frequency of PTC in patients with nodular goiter. Our aim was to investigate the effect of L-thyroxine (LT(4)) on the frequency of PTC diagnosed by cytology in a large series of patients with nodular goiter untreated (n=20 055) or treated with L-T(4) (n=7859). L-T(4)-treated patients with respect to untreated patients presented significantly lower serum TSH (median, interquartile range: 0.30 muU/ml, 0.08-0.62 microU/ml versus 0.70 muU/ml, 0.38-1.14 muU/ml; P<0.0001) and prevalence of PTC (3.2 vs 5.1%; P<0.0001). The frequency of PTC was closely related to serum TSH, with it being lowest in patients with TSH below the normal range (<0.4 muU/ml; 189/10 059, 1.9%) and highest in patients with TSH above the normal range (>3.4 muU/ml; 21/127, 16.5%), also showing a progressive increase from the lower to the upper quartile of normal range. A significantly higher proportion of L-T(4)-treated patients (6650/7859, 84.6%) had serum TSH below the median (0.90 muU/ml) with respect to untreated patients (12,599/20,055, 62.8%; chi(2) P value <0.0001), with it being included in the range of TSH associated with a lower frequency of PTC. The relationship between serum TSH and frequency of PTC was unrelated to the type of nodularity (solitary versus multinodular) and was not age dependent. In conclusion, patients with nodular goiter, treatment with L-T(4) is responsible for the reduction of serum TSH and is associated with a decreased frequency of PTC.
Authors:
E Fiore; T Rago; M A Provenzale; M Scutari; C Ugolini; F Basolo; G Di Coscio; P Miccoli; L Grasso; A Pinchera; P Vitti
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-18
Journal Detail:
Title:  Endocrine-related cancer     Volume:  17     ISSN:  1479-6821     ISO Abbreviation:  Endocr. Relat. Cancer     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-19     Completed Date:  2010-06-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9436481     Medline TA:  Endocr Relat Cancer     Country:  England    
Other Details:
Languages:  eng     Pagination:  231-9     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, University of Pisa, Via Paradisa 2, 56100 Pisa, Italy. e.fiore@ao-pisa.toscana.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Carcinoma, Papillary / blood,  epidemiology*
Cross-Sectional Studies
Down-Regulation
Female
Goiter, Nodular / blood*,  complications,  drug therapy*,  epidemiology
Humans
Incidence
Male
Middle Aged
Odds Ratio
Thyroid Neoplasms / blood,  epidemiology*
Thyrotropin / blood*
Thyroxine / therapeutic use*
Chemical
Reg. No./Substance:
7488-70-2/Thyroxine; 9002-71-5/Thyrotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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