Evaluation of Thyroid Swellings for Incidence of Thyroid Cancer and their Association with Serum Thyroid Stimulating Hormone and Triglyceride Levels: A Cross-sectional Study

Abstract

Introduction: Earlier, several studies have been evaluated the role of Thyroid Stimulating Hormone (TSH) as a predictor of thyroid cancer in patients presenting with thyroid swelling but it remains unclear. Aim: To evaluate the role of TSH in non neoplastic tumours and neoplastic tumours and its association with various types of thyroid neoplastic tumours. Materials and Methods: In this retrospective cross-sectional study, the records of 138 patients from March 2017 to February 2019 with thyroid swelling were evaluated and analysis was done in October 2020. Examination of following parameters like age, sex, Free Triiodothyronine (FT3), Free Tetraiodothyronine (FT4), Thyroid Stimulating Hormone (TSH), Total Cholesterol (TC), Triglycerides (TGL), Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL) cholesterol were done. All the patients were divided into two groups viz., neoplastic and non neoplastic on the basis of Fine Needle Aspiration Cytology (FNAC) diagnosis. One-way ANOVA and Student's t-test were used for the analysis of thyroid tumour patients. The p-value of <0.05 was considered to be significant. Results: Out of 138 cases identified, 38 cases (27.5%) were between 10-30 years of age, 90 cases (65.2%) between 31- 50 years and 10 cases (7.3%) between 51-70 years of age. The incidence of thyroid pathology was significantly high in patients with age >30 years of age as compared to ≤30 years of age patients (27.5% vs 72.5%, Υ2=55.7, p-value <0.05). The incidence of thyroid tumours was high in females than in males and is statistically significant (20.3% vs 79.7%, Υ2=97.44, p-value <0.05). Out of 138 patients, euthyroid was observed in 71 patients, overt hypothyroidism in 37, Subclinical Hypothyroidism (SCH) in 14, overt hyperthyroidism in 11 and subclinical hyperthyroidism in four patients. Hypothyroidism was found in 50% of neoplastic tumour patients which is significantly high as compared to non neoplastic tumour patients. Significantly higher levels of TSH were noted in neoplastic group as compared to non neoplastic group (p-value <0.05). Conclusion: The high serum concentrations of TSH in patients with thyroid swellings should be evaluated properly for the early diagnosis of thyroid cancers. The data from our study provided the evidence for a possible association of TSH, TGL with thyroid cancer.