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A meta-analysis of the value of serum TSH concentration in the diagnosis of differentiated thyroid cancer in patients with thyroid nodules

In recent years, most studies believe that high TSH level is positively correlated with the incidence of thyroid cancer, but it is still controversial. For this reason, the purpose of this study is to analyze the correlation between preoperative TSH level and thyroid malignant nodules using patholog...

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Published in:Heliyon 2024-01, Vol.10 (2), p.e24391-e24391, Article e24391
Main Authors: Fan, Xiao-Yu, You, Wei, Chen, Yao, Nie, Chen-Cong, Wang, Xue-Lian, Lei, Cheng, Song, Juan, Luo, Huai-Li
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description In recent years, most studies believe that high TSH level is positively correlated with the incidence of thyroid cancer, but it is still controversial. For this reason, the purpose of this study is to analyze the correlation between preoperative TSH level and thyroid malignant nodules using pathological diagnosis as the gold standard. To evaluate the role of serum TSH in predicting malignancy of thyroid nodules with uncertain cytology.As an important member of the hypothalamus–pituitary–thyroid axis in the endocrine system, TSH plays a crucial role in regulating the growth, differentiation, and function of thyroid cells (Zhang et al., 2023) [1]. Therefore, it has always been considered closely related to TC. Currently, most studies have compared the TSH levels of TC patients and individuals with benign thyroid disease or healthy controls. These findings from various studies indicated that TC patients often demonstrate elevated TSH levels, even when their TSH falls within the normal range. However, it is important to highlight that the current evidence primarily relies on cross-sectional studies, which mainly describe a phenomenon without establishing causal relationships. The involvement of TSH in the early onset or late progression of TC remains unknown, the interaction between TSH and other factors and how it affects TC is not well understood (Gubbi et al., 2020) [2].Symptoms of thyroid cancer are usually insidious, and early thyroid cancer often has no obvious clinical symptoms. Therefore, early detection and early treatment are particularly important, and how to improve the preoperative diagnosis rate of thyroid nodules is also a problem that clinicians pay close attention to. To evaluate the value of serum TSH concentration in the diagnosis of differentiated thyroid carcinoma in patients with thyroid nodules. Our study searched databases in both Chinese and English.China Academic Journals FULL-text Database (CNKI), China Online Journals, Chinese Scientific Journals database and Chinese Biomedical Literature Database (CBM) were searched by computer. The English literature was established by PubMed, Embase, Cochrane Library, Web of Science and other databases until June 2022 to search for relevant literatures on the diagnostic test of serum TSH concentration in patients with thyroid nodule. The literatures that met the criteria were screened, the data were extracted, and the literature quality was evaluated. The sensitivity, specificity, positive likeli
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For this reason, the purpose of this study is to analyze the correlation between preoperative TSH level and thyroid malignant nodules using pathological diagnosis as the gold standard. To evaluate the role of serum TSH in predicting malignancy of thyroid nodules with uncertain cytology.As an important member of the hypothalamus–pituitary–thyroid axis in the endocrine system, TSH plays a crucial role in regulating the growth, differentiation, and function of thyroid cells (Zhang et al., 2023) [1]. Therefore, it has always been considered closely related to TC. Currently, most studies have compared the TSH levels of TC patients and individuals with benign thyroid disease or healthy controls. These findings from various studies indicated that TC patients often demonstrate elevated TSH levels, even when their TSH falls within the normal range. However, it is important to highlight that the current evidence primarily relies on cross-sectional studies, which mainly describe a phenomenon without establishing causal relationships. The involvement of TSH in the early onset or late progression of TC remains unknown, the interaction between TSH and other factors and how it affects TC is not well understood (Gubbi et al., 2020) [2].Symptoms of thyroid cancer are usually insidious, and early thyroid cancer often has no obvious clinical symptoms. Therefore, early detection and early treatment are particularly important, and how to improve the preoperative diagnosis rate of thyroid nodules is also a problem that clinicians pay close attention to. To evaluate the value of serum TSH concentration in the diagnosis of differentiated thyroid carcinoma in patients with thyroid nodules. Our study searched databases in both Chinese and English.China Academic Journals FULL-text Database (CNKI), China Online Journals, Chinese Scientific Journals database and Chinese Biomedical Literature Database (CBM) were searched by computer. The English literature was established by PubMed, Embase, Cochrane Library, Web of Science and other databases until June 2022 to search for relevant literatures on the diagnostic test of serum TSH concentration in patients with thyroid nodule. The literatures that met the criteria were screened, the data were extracted, and the literature quality was evaluated. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of the method for the diagnosis of differentiated thyroid carcinoma were calculated and summarized. The receiver operating characteristic (SROC) curve was drawn and the area under the curve was obtained. A total of 23 diagnostic tests were included (5348 lesions). Meta-analysis showed that the combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of serum TSH concentration in the diagnosis of differentiated thyroid carcinoma were 0.64, 0.72, 2.511, 0.386 and 7.14, respectively. The area under SROC curve (AUC) was 0.79, and the Q index was 0.7283, indicating no statistically significant difference. Based on current evidence, detection of serum TSH concentration in thyroid nodule patients has high sensitivity and specificity for the diagnosis of differentiated thyroid cancer, which has good clinical application value. However, other auxiliary examinations are still needed to improve the diagnosis rate. •The results of this study proved that serum TSH level is one of the effective indicators to predict thyroid cancer.•In addition, future studies should evaluate whether TSH in combination with other tests improves diagnostic sensitivity.•The results of this study suggest that elevated serum TSH concentration is an independent risk factor for differentiated thyroid cancer.•The results of this study indicate that the increase of serum TSH concentration is also one of the factors affecting cervical lymph node metastasis.•Serum TSH can be used as an auxiliary clinical indicator to judge benign and malignant thyroid nodules.</description><identifier>ISSN: 2405-8440</identifier><identifier>EISSN: 2405-8440</identifier><identifier>DOI: 10.1016/j.heliyon.2024.e24391</identifier><identifier>PMID: 38312537</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Diagnosis, Sensitivity and specificity ; Thyroid cancer,TSH,Meta-analysis</subject><ispartof>Heliyon, 2024-01, Vol.10 (2), p.e24391-e24391, Article e24391</ispartof><rights>2024 The Authors</rights><rights>2024 The Authors.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-1793eb3c2e7eaf8e0d4f753d1176c998d1ef445d93265f3b1047f0ed0e63f4693</cites><orcidid>0000-0003-0812-8933</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S2405844024004225$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3549,27924,27925,45780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38312537$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fan, Xiao-Yu</creatorcontrib><creatorcontrib>You, Wei</creatorcontrib><creatorcontrib>Chen, Yao</creatorcontrib><creatorcontrib>Nie, Chen-Cong</creatorcontrib><creatorcontrib>Wang, Xue-Lian</creatorcontrib><creatorcontrib>Lei, Cheng</creatorcontrib><creatorcontrib>Song, Juan</creatorcontrib><creatorcontrib>Luo, Huai-Li</creatorcontrib><title>A meta-analysis of the value of serum TSH concentration in the diagnosis of differentiated thyroid cancer in patients with thyroid nodules</title><title>Heliyon</title><addtitle>Heliyon</addtitle><description>In recent years, most studies believe that high TSH level is positively correlated with the incidence of thyroid cancer, but it is still controversial. For this reason, the purpose of this study is to analyze the correlation between preoperative TSH level and thyroid malignant nodules using pathological diagnosis as the gold standard. To evaluate the role of serum TSH in predicting malignancy of thyroid nodules with uncertain cytology.As an important member of the hypothalamus–pituitary–thyroid axis in the endocrine system, TSH plays a crucial role in regulating the growth, differentiation, and function of thyroid cells (Zhang et al., 2023) [1]. Therefore, it has always been considered closely related to TC. Currently, most studies have compared the TSH levels of TC patients and individuals with benign thyroid disease or healthy controls. These findings from various studies indicated that TC patients often demonstrate elevated TSH levels, even when their TSH falls within the normal range. However, it is important to highlight that the current evidence primarily relies on cross-sectional studies, which mainly describe a phenomenon without establishing causal relationships. The involvement of TSH in the early onset or late progression of TC remains unknown, the interaction between TSH and other factors and how it affects TC is not well understood (Gubbi et al., 2020) [2].Symptoms of thyroid cancer are usually insidious, and early thyroid cancer often has no obvious clinical symptoms. Therefore, early detection and early treatment are particularly important, and how to improve the preoperative diagnosis rate of thyroid nodules is also a problem that clinicians pay close attention to. To evaluate the value of serum TSH concentration in the diagnosis of differentiated thyroid carcinoma in patients with thyroid nodules. Our study searched databases in both Chinese and English.China Academic Journals FULL-text Database (CNKI), China Online Journals, Chinese Scientific Journals database and Chinese Biomedical Literature Database (CBM) were searched by computer. The English literature was established by PubMed, Embase, Cochrane Library, Web of Science and other databases until June 2022 to search for relevant literatures on the diagnostic test of serum TSH concentration in patients with thyroid nodule. The literatures that met the criteria were screened, the data were extracted, and the literature quality was evaluated. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of the method for the diagnosis of differentiated thyroid carcinoma were calculated and summarized. The receiver operating characteristic (SROC) curve was drawn and the area under the curve was obtained. A total of 23 diagnostic tests were included (5348 lesions). Meta-analysis showed that the combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of serum TSH concentration in the diagnosis of differentiated thyroid carcinoma were 0.64, 0.72, 2.511, 0.386 and 7.14, respectively. The area under SROC curve (AUC) was 0.79, and the Q index was 0.7283, indicating no statistically significant difference. Based on current evidence, detection of serum TSH concentration in thyroid nodule patients has high sensitivity and specificity for the diagnosis of differentiated thyroid cancer, which has good clinical application value. However, other auxiliary examinations are still needed to improve the diagnosis rate. •The results of this study proved that serum TSH level is one of the effective indicators to predict thyroid cancer.•In addition, future studies should evaluate whether TSH in combination with other tests improves diagnostic sensitivity.•The results of this study suggest that elevated serum TSH concentration is an independent risk factor for differentiated thyroid cancer.•The results of this study indicate that the increase of serum TSH concentration is also one of the factors affecting cervical lymph node metastasis.•Serum TSH can be used as an auxiliary clinical indicator to judge benign and malignant thyroid nodules.</description><subject>Diagnosis, Sensitivity and specificity</subject><subject>Thyroid cancer,TSH,Meta-analysis</subject><issn>2405-8440</issn><issn>2405-8440</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNqFkc1q3DAUhUVoScI0j5DiZTee6s-WtSohtE0g0EWTtZClq4wG25pKcsq8Qp66mng6dFe00M8937noHoSuCV4TTNrP2_UGBr8P05piytdAOZPkDF1Sjpu64xy_--d8ga5S2mKMSdO1UrBzdME6RmjDxCV6valGyLrWkx72yacquCpvoHrRwwyHS4I4j9Xjz7vKhMnAlKPOPkyVn9501uvnKRxB652DWDReZ7Clvo_B28roAsYDsStsKafqt8-bU30Kdh4gfUDvnR4SXB33FXr69vXx9q5--PH9_vbmoTactrkmQjLomaEgQLsOsOVONMwSIlojZWcJOM4bKxltG8d6grlwGCyGljneSrZC94uvDXqrdtGPOu5V0F69PYT4rHTM3gygHMi-N0L3jbUFtZL0TggqjXVMUNEXr0-L1y6GXzOkrEafDAyDniDMSVFJKS-DLmuFmkVqYkgpgju1JlgdUlVbdUxVHVJVS6qF-3hsMfcj2BP1N8Mi-LIIoAztxUNUyZQpG7A-gsnlV_4_Lf4AcfO4tg</recordid><startdate>20240130</startdate><enddate>20240130</enddate><creator>Fan, Xiao-Yu</creator><creator>You, Wei</creator><creator>Chen, Yao</creator><creator>Nie, Chen-Cong</creator><creator>Wang, Xue-Lian</creator><creator>Lei, Cheng</creator><creator>Song, Juan</creator><creator>Luo, Huai-Li</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0812-8933</orcidid></search><sort><creationdate>20240130</creationdate><title>A meta-analysis of the value of serum TSH concentration in the diagnosis of differentiated thyroid cancer in patients with thyroid nodules</title><author>Fan, Xiao-Yu ; You, Wei ; Chen, Yao ; Nie, Chen-Cong ; Wang, Xue-Lian ; Lei, Cheng ; Song, Juan ; Luo, Huai-Li</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-1793eb3c2e7eaf8e0d4f753d1176c998d1ef445d93265f3b1047f0ed0e63f4693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Diagnosis, Sensitivity and specificity</topic><topic>Thyroid cancer,TSH,Meta-analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fan, Xiao-Yu</creatorcontrib><creatorcontrib>You, Wei</creatorcontrib><creatorcontrib>Chen, Yao</creatorcontrib><creatorcontrib>Nie, Chen-Cong</creatorcontrib><creatorcontrib>Wang, Xue-Lian</creatorcontrib><creatorcontrib>Lei, Cheng</creatorcontrib><creatorcontrib>Song, Juan</creatorcontrib><creatorcontrib>Luo, Huai-Li</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Heliyon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fan, Xiao-Yu</au><au>You, Wei</au><au>Chen, Yao</au><au>Nie, Chen-Cong</au><au>Wang, Xue-Lian</au><au>Lei, Cheng</au><au>Song, Juan</au><au>Luo, Huai-Li</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A meta-analysis of the value of serum TSH concentration in the diagnosis of differentiated thyroid cancer in patients with thyroid nodules</atitle><jtitle>Heliyon</jtitle><addtitle>Heliyon</addtitle><date>2024-01-30</date><risdate>2024</risdate><volume>10</volume><issue>2</issue><spage>e24391</spage><epage>e24391</epage><pages>e24391-e24391</pages><artnum>e24391</artnum><issn>2405-8440</issn><eissn>2405-8440</eissn><abstract>In recent years, most studies believe that high TSH level is positively correlated with the incidence of thyroid cancer, but it is still controversial. For this reason, the purpose of this study is to analyze the correlation between preoperative TSH level and thyroid malignant nodules using pathological diagnosis as the gold standard. To evaluate the role of serum TSH in predicting malignancy of thyroid nodules with uncertain cytology.As an important member of the hypothalamus–pituitary–thyroid axis in the endocrine system, TSH plays a crucial role in regulating the growth, differentiation, and function of thyroid cells (Zhang et al., 2023) [1]. Therefore, it has always been considered closely related to TC. Currently, most studies have compared the TSH levels of TC patients and individuals with benign thyroid disease or healthy controls. These findings from various studies indicated that TC patients often demonstrate elevated TSH levels, even when their TSH falls within the normal range. However, it is important to highlight that the current evidence primarily relies on cross-sectional studies, which mainly describe a phenomenon without establishing causal relationships. The involvement of TSH in the early onset or late progression of TC remains unknown, the interaction between TSH and other factors and how it affects TC is not well understood (Gubbi et al., 2020) [2].Symptoms of thyroid cancer are usually insidious, and early thyroid cancer often has no obvious clinical symptoms. Therefore, early detection and early treatment are particularly important, and how to improve the preoperative diagnosis rate of thyroid nodules is also a problem that clinicians pay close attention to. To evaluate the value of serum TSH concentration in the diagnosis of differentiated thyroid carcinoma in patients with thyroid nodules. Our study searched databases in both Chinese and English.China Academic Journals FULL-text Database (CNKI), China Online Journals, Chinese Scientific Journals database and Chinese Biomedical Literature Database (CBM) were searched by computer. The English literature was established by PubMed, Embase, Cochrane Library, Web of Science and other databases until June 2022 to search for relevant literatures on the diagnostic test of serum TSH concentration in patients with thyroid nodule. The literatures that met the criteria were screened, the data were extracted, and the literature quality was evaluated. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of the method for the diagnosis of differentiated thyroid carcinoma were calculated and summarized. The receiver operating characteristic (SROC) curve was drawn and the area under the curve was obtained. A total of 23 diagnostic tests were included (5348 lesions). Meta-analysis showed that the combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of serum TSH concentration in the diagnosis of differentiated thyroid carcinoma were 0.64, 0.72, 2.511, 0.386 and 7.14, respectively. The area under SROC curve (AUC) was 0.79, and the Q index was 0.7283, indicating no statistically significant difference. Based on current evidence, detection of serum TSH concentration in thyroid nodule patients has high sensitivity and specificity for the diagnosis of differentiated thyroid cancer, which has good clinical application value. However, other auxiliary examinations are still needed to improve the diagnosis rate. •The results of this study proved that serum TSH level is one of the effective indicators to predict thyroid cancer.•In addition, future studies should evaluate whether TSH in combination with other tests improves diagnostic sensitivity.•The results of this study suggest that elevated serum TSH concentration is an independent risk factor for differentiated thyroid cancer.•The results of this study indicate that the increase of serum TSH concentration is also one of the factors affecting cervical lymph node metastasis.•Serum TSH can be used as an auxiliary clinical indicator to judge benign and malignant thyroid nodules.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38312537</pmid><doi>10.1016/j.heliyon.2024.e24391</doi><orcidid>https://orcid.org/0000-0003-0812-8933</orcidid><oa>free_for_read</oa></addata></record>
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Thyroid cancer,TSH,Meta-analysis
title A meta-analysis of the value of serum TSH concentration in the diagnosis of differentiated thyroid cancer in patients with thyroid nodules
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