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High Body Mass Index and Thyroid Stimulating Hormone Levels Do Not Affect Thyroid Nodule Selection for Fine-Needle Aspiration Biopsy after Ultrasound Evaluation

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주제분류의학일반

초록

Background and Objectives: This study was to evaluate whether high body mass index (BMI) or thyroid stimulating hormone (TSH) level would affect selecting thyroid nodule for fine-needle aspiration biopsy (FNA) after ultrasound (US) evaluation. Materials and Methods: A total of 3155 thyroid nodules (2159 benign and 996 malignant nodules) were included. Four grades of BMI and three levels of TSH were applied for grouping. US features of the thyroid nodules were divided into ‘probably benign’ and ‘suspicious for malignancy’ categories. Patients were grouped according to gender and univariate and multivariate logistic regression analysis were used to find the association between variables and malignancy. Results: TSH levels were significantly higher in the malignant group (p<0.001). The grades of BMI did not show difference between the malignant and benign groups (females, p=0.074 and males, p=0.157). Younger age and ‘suspicious for malignancy’ US category were independent risk factors for malignancy in both genders. In females, a high TSH level (odds ratio=1.010, p<0.001) had significant association with malignancy. Except for younger age (odds ratio=0.998, p<0.001), no variable in nodules with ‘probably benign’ US category was significantly associated with malignancy. Conclusion: High TSH levels were more frequent in thyroid malignancy group, but neither high BMI nor high TSH level give additional information for FNA selection after US.

Abstract

Background and Objectives: This study was to evaluate whether high body mass index (BMI) or thyroid stimulating hormone (TSH) level would affect selecting thyroid nodule for fine-needle aspiration biopsy (FNA) after ultrasound (US) evaluation. Materials and Methods: A total of 3155 thyroid nodules (2159 benign and 996 malignant nodules) were included. Four grades of BMI and three levels of TSH were applied for grouping. US features of the thyroid nodules were divided into ‘probably benign’ and ‘suspicious for malignancy’ categories. Patients were grouped according to gender and univariate and multivariate logistic regression analysis were used to find the association between variables and malignancy. Results: TSH levels were significantly higher in the malignant group (p<0.001). The grades of BMI did not show difference between the malignant and benign groups (females, p=0.074 and males, p=0.157). Younger age and ‘suspicious for malignancy’ US category were independent risk factors for malignancy in both genders. In females, a high TSH level (odds ratio=1.010, p<0.001) had significant association with malignancy. Except for younger age (odds ratio=0.998, p<0.001), no variable in nodules with ‘probably benign’ US category was significantly associated with malignancy. Conclusion: High TSH levels were more frequent in thyroid malignancy group, but neither high BMI nor high TSH level give additional information for FNA selection after US.

참고문헌 (41)

  1. Davies L, "Increasing incidence of thyroid cancer in the United States, 1973-2002", JAMA, 295(18), pp.2164~2167 (2006)
  2. 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2008", Cancer Research and Treatment, 43(1), pp.1~11 (2011), 대한암학회
  3. Enewold L, "Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980-2005", Cancer Epidemiol Biomarkers Prev, 18(3), pp.784~791 (2009)
  4. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, "Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer", Thyroid, 19(11), pp.1167~1214 (2009)
  5. Meinhold CL, "Nonradiation risk factors for thyroid cancer in the US Radiologic Technologists Study", Am J Epidemiol, 171(2), pp.242~252 (2010)
  6. Ogden CL, "The epidemiology of obesity", Gastroenterology, 132(6), pp.2087~2102 (2007)
  7. Kitahara CM, "Obesity and thyroid cancer risk among U.S. men and women: A pooled analysis of five prospective studies", Cancer Epidemiol Biomarkers Prev, 20(3), pp.464~472 (2011)
  8. Han JM, "Obesity is a risk factor for thyroid cancer in a large, ultrasonographically screened population", Eur J Endocrinol, 168(6), pp.879~886 (2013)
  9. Kim HK, "Higher TSH level is a risk factor for differentiated thyroid cancer", Clin Endocrinol (Oxf), 78(3), pp.472~477 (2013)
  10. Haymart MR, "Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage", J Clin Endocrinol Metab, 93(3), pp.809~814 (2008)
  11. Boelaert K, "Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration", J Clin Endocrinol Metab, 91(11), pp.4295~4301 (2006)
  12. Diez JJ, "Relationship between thyrotropin and body mass index in euthyroid subjects", Exp Clin Endocrinol Diabetes, 119(3), pp.144~150 (2011)
  13. Fox CS, "Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample", Arch Intern Med, 168(6), pp.587~592 (2008)
  14. Rotondi M, "Raised serum TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism?", Eur J Endocrinol, 160(3), pp.403~408 (2009)
  15. Kwak JY, "How to combine ultrasound and cytological information in decision making about thyroid nodules", Eur Radiol, 19(8), pp.1923~1931 (2009)
  16. Kwak JY, "Value of US correlation of a thyroid nodule with initially benign cytologic results", Radiology, 254(1), pp.292~300 (2010)
  17. Moon HJ, "The role of BRAFV600E mutation and ultrasonography for the surgical management of a thyroid nodule suspicious for papillary thyroid carcinoma on cytology", Ann Surg Oncol, 16(11), pp.3125~3131 (2009)
  18. Yoon JH, "Inadequate cytology in thyroid nodules: should we repeat aspiration or follow-up?", Ann Surg Oncol, 18(5), pp.1282~1289 (2011)
  19. Obesity: Preventing and managing the global epidemic, , World Health Organization, ~, pp.World Health Organization Technical Report Series 894 (2000)
  20. Kim EK, "New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid", AJR Am J Roentgenol, 178(3), pp.687~691 (2002)
  21. Iacobellis G, "Relationship of thyroid function with body mass index, leptin, insulin sensitivity and adiponectin in euthyroid obese women", Clin Endocrinol (Oxf), 62(4), pp.487~491 (2005)
  22. Kim B, "Thyroid hormone as a determinant of energy expenditure and the basal metabolic rate", Thyroid, 18(2), pp.141~144 (2008)
  23. Reinehr T, "Obesity and thyroid function", Mol Cell Endocrinol, 316(2), pp.165~171 (2010)
  24. Considine RV, "Serum immunoreactive-leptin concentrations in normal-weight and obese humans", N Engl J Med, 334(5), pp.292~295 (1996)
  25. Marzullo P, "Investigations of thyroid hormones and antibodies in obesity: Leptin levels are associated with thyroid autoimmunity independent of bioanthropometric, hormonal, and weight-related determinants", J Clin Endocrinol Metab, 95(8), pp.3965~3972 (2010)
  26. Pazaitou-Panayiotou K, "Obesity and thyroid cancer: Epidemiologic associations and underlying mechanisms", Obes Rev, 14(12), pp.1006~1022 (2013)
  27. Kimura T, "Regulation of thyroid cell proliferation by TSH and other factors: a critical evaluation of in vitro models", Endocr Rev, 22(5), pp.631~656 (2001)
  28. McLeod DS, "Thyrotropin and thyroid cancer diagnosis: a systematic review and dose-response meta-analysis", J Clin Endocrinol Metab, 97(8), pp.2682~2692 (2012)
  29. Mazzaferri EL, "Thyroid cancer and Graves' disease: the controversy ten years later", Endocr Pract, 6(2), pp.221~225 (2000)
  30. Park J, "Metformin blocks progression of obesity-activated thyroid cancer in a mouse model", Oncotarget, 7(23), pp.34832~34844 (2016)
  31. Shi Y, "Expression of thyrotrophin receptor gene in thyroid carcinoma is associated with a good prognosis", Clin Endocrinol (Oxf), 39(3), pp.269~274 (1993)
  32. Fiore E, "Lower levels of TSH are associated with a lower risk of papillary thyroid cancer in patients with thyroid nodular disease: thyroid autonomy may play a protective role", Endocr Relat Cancer, 16(4), pp.1251~1260 (2009)
  33. Balakrishnan VS, "Low BMI linked to worse colorectal cancer outcomes", Lancet Oncol, 16(16), pp.e593~ (2015)
  34. Nakagawa T, "Prognostic value of body mass index and change in body weight in postoperative outcomes of lung cancer surgery", Interact Cardiovasc Thorac Surg, 23(4), pp.560~566 (2016)
  35. Keinan-Boker L, "Measured adolescent body mass index and adult breast cancer in a cohort of 951,480 women", Breast Cancer Res Treat, 158(1), pp.157~167 (2016)
  36. Magister MJ, "Association of thyroid nodule size and Bethesda class with rate of malignant disease", JAMA Otolaryngol Head Neck Surg, 141(12), pp.1089~1095 (2015)
  37. Cavallo A, "Thyroid nodule size at ultrasound as a predictor of malignancy and final pathologic size", Thyroid, 27(5), pp.641~650 (2017)
  38. Kamran SC, "Thyroid nodule size and prediction of cancer", J Clin Endocrinol Metab, 98(2), pp.564~570 (2013)
  39. 홍민지, "Impact of Nodule Size on Malignancy Risk Differs according to the Ultrasonography Pattern of Thyroid Nodules", Korean Journal of Radiology, 19(3), pp.534~541 (2018), 대한영상의학회[DOI]
  40. Mi-Jung Lee, "Cytological Results of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules: Emphasis on Correlation with Sonographic Findings", Yonsei Medical Journal, 52(5), pp.838~844 (2011), 연세대학교의과대학
  41. Mehany MT, "Immunoradiometric assay for the in-vitro determination of thyroid stimulating hormone in human serum and plasma using solid phase anti-TSH cellulose particles", J Radioanal Nucl Chem, 265(1), pp.61~71 (2005)

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