Abstract
Thyrotropin (TSH) is thought as a risk factor for thyroid cancer. However, the effect of serum TSH might depend on histological types of thyroid cancer. We searched for related studies including serum TSH as an exposure and thyroid cancer as a result in PUBMED, EMBASE and Chinese National Knowledge Infrastructure up to April 21, 2016. This meta-analysis included 22 articles with 53,538 participants. When comparing all histological thyroid cancer, the pooled odds ratios of thyroid cancer in patients with nodules was found to increase significantly with higher serum TSH concentrations for differentiated thyroid carcinoma (1.88 vs .1.48, P = 0.0000) and papillary thyroid carcinoma (2.08 vs. 1.48, P = 0.0006). Each 1 mU/L increase of serum TSH was associated with 14% greater risk of thyroid cancer for all histological thyroid cancer, 16% for differentiated thyroid carcinoma and 22% for papillary thyroid carcinoma. In addition, high serum TSH was associated with a reduced risk for follicular thyroid carcinoma (OR = 0.73, 95% CI: 0.52, 1.02). This meta-analysis suggested high serum TSH concentration is risky for papillary thyroid carcinoma but not for follicular thyroid carcinoma.
Highlights
Thyroid cancer is the most common malignant tumor of the endocrine system [1]
This study provided a new view for a potential relation between serum TSH and risk of thyroid cancer by overall meta-analysis and dose-response meta-analysis
This study indicated that the risk of thyroid cancer for higher serum TSH depends on histological types
Summary
Thyroid cancer is the most common malignant tumor of the endocrine system [1]. In 2003, the American Cancer Society reported an incidence of 1/10000 in the USA. The incidence of thyroid cancer is rising faster than any other malignancy [1]. Thyroid carcinoma according to the histological type can be classified as differentiated and undifferentiated. TSH plays a role in thyroid growth and organogenesis [3, 4]. It has been reported that higher serum TSH concentration is associated with an increased risk of thyroid cancer [5]. The risk of thyroid malignancy to serum TSH might depend on histological types. In order to address this issue, the patients with thyroid nodule and different histological thyroid cancer, including DTC, PTC as well as FTC, were included to analyze the association of thyroid cancer and serum TSH. An overall and dose-response meta-analysis were performed for this serum TSH and thyroid cancer risk by histological type
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