| 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. | |
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MedLine Citation:
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PMID: 20167722 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-02-18 |
Journal Detail:
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Title: Endocrine-related cancer Volume: 17 ISSN: 1479-6821 ISO Abbreviation: Endocr. Relat. Cancer Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-02-19 Completed Date: 2010-06-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9436481 Medline TA: Endocr Relat Cancer Country: England |
Other Details:
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Languages: eng Pagination: 231-9 Citation Subset: IM |
Affiliation:
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Department of Endocrinology, University of Pisa, Via Paradisa 2, 56100 Pisa, Italy. e.fiore@ao-pisa.toscana.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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