25-Hydroxyvitamin D and TSH as Risk Factors or Prognostic Markers in Thyroid Carcinoma
Danilovic DL, Ferraz-de-Souza B, Fabri AW, Santana NO, Kulcsar MA, Cernea CR, Marui S, Hoff AO
PloS one · 27 citations
How it was studied
- Design
- Cross-sectional study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- Government
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Government
- CNPq (National Counsel of Technological and Scientific Development)
- Grants
- Conselho Nacional de Desenvolvimento Científico e Tecnológico (USP1676)
Based on 2 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2016-10-13 · PLoS One · vol. 11 · issue 10 · p. e0164550
- Publisher
- Public Library of Science
- Cited
- 58 citations · more than 96% of similar papers · 4.6× the field average
- Impact
- Top 10% most cited in its field
- References
- 66 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Thyroid Cancer Diagnosis and Treatment · Vitamin D Research Studies · Thyroid Disorders and Treatments
- Keywords
- Medicine, Thyroid cancer, Internal medicine, Thyroid carcinoma, Thyroid nodules, Thyroid, Odds ratio, Quartile, Cancer, Gastroenterology, Incidence (geometry), Oncology, Confidence interval
- MeSH
- humans, carcinoma, carcinoma, papillary, thyroid neoplasms, lymphatic metastasis, vitamin d deficiency, thyrotropin, vitamin d, prognosis, risk factors, retrospective studies, cross-sectional studies, adult, aged, middle aged, female, male, thyroid cancer, papillary
8 authors
From BR
- Debora Lúcia Seguro Danilovic · correspondingInstituto do Câncer do Estado de São Paulo; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
- Bruno Ferraz‐de‐Souza · correspondingHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
- Amanda Wictky Fabri · correspondingHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
- Nathalie Oliveira de Santana · correspondingHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
- Marco Aurélio Vamondes Kulcsar · correspondingInstituto do Câncer do Estado de São Paulo
- Cláudio Roberto Cernea · correspondingInstituto do Câncer do Estado de São Paulo
Abstract
Objective
The increasing incidence of thyroid nodules demands identification of risk factors for malignant disease. Several studies suggested the association of higher TSH levels with cancer, but influence of 25-hydroxyvitamin D (25OHD) is controversial. This study aimed to identify the relationship of thyroid cancer with higher TSH levels and hypovitaminosis D and to evaluate their influence on prognostic characteristics of papillary thyroid carcinomas (PTC).
Methods
We retrospectively evaluated 433 patients submitted to thyroidectomy for thyroid nodules. Patients were categorized according to quartiles of TSH and 25OHD levels. Clinicopathological features were analyzed.
Results
Subjects with thyroid carcinomas were more frequently male and younger compared to those with benign disease. Their median TSH levels were higher and adjusted odds-ratio (OR) for cancer in the highest-quartile of TSH (> 2.4 mUI/mL) was 2.36 (1.36-4.09). Although vitamin D deficiency/insufficiency was prevalent in our cohort (84%), no significant differences in 25OHD levels or quartile distribution were observed between benign and malignant cases. Among 187 patients with PTC, analyses of prognostic features revealed increased risk of lymph nodes metastases for subjects with highest-quartile TSH levels (OR = 3.7, p = 0.029). Decreased 25OHD levels were not overtly associated with poor prognosis in PTC.
Conclusions
In this cross-sectional cohort, higher TSH levels increased the risk of cancer in thyroid nodules and influenced its prognosis, particularly favoring lymph nodes metastases. On the other hand, no association was found between 25OHD levels and thyroid carcinoma risk or prognosis, suggesting that serum 25OHD determination may not contribute to risk assessment workup of thyroid nodules.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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