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Background <p>Thyroid swellings are a common clinical finding, often posing diagnostic challenges in distinguishing benign from malignant nodules. While fine needle aspiration cytology (FNAC) is the gold standard, its limitations necessitate additional tools. This study investigates the utility of thyroid function tests (TFTs), particularly thyroid-stimulating hormone (TSH) levels, in predicting the nature of thyroid swellings.</p> Methods <p>This retrospective study included 50 patients aged 12–65 years who underwent thyroid surgery for thyroid swellings at a tertiary care hospital in Karnataka, India. Preoperative TFTs, FNAC findings, and postoperative histopathological examinations were analyzed. TSH levels were categorized into ranges to assess their correlation with histopathological diagnoses. Statistical significance was evaluated using Chi-square and t-tests, with <i>p</i> &lt; 0.05 considered significant.</p> Results <p>Among the 50 patients, 12 (24%) had malignant nodules, while 38 (76%) were benign. TSH levels were significantly higher in malignant cases (mean 5.22 µIU/ml) compared to benign cases (mean 2.59 µIU/ml, <i>p</i> &lt; 0.001). Elevated TSH (&gt; 4.5 µIU/ml) was associated with papillary carcinoma in 6 cases, and malignancy was less likely at lower TSH ranges. No significant differences were observed for T3 and T4 levels (<i>p</i> &gt; 0.05). FNAC and histopathology showed partial concordance, with histopathology detecting 12 malignancies compared to 7 by FNAC.</p> Conclusion <p>Elevated TSH levels are significantly associated with malignant thyroid nodules, suggesting not only their role as a predictive marker but also as an early indicator for potential malignancy in follow up. Incorporating TSH with FNAC and imaging findings could improve diagnostic accuracy and guide management decisions, minimizing unnecessary interventions.</p>

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Role of Thyroid Function Test as a Predictor of Benign or Malignant Nature of Thyroid Swelling

  • 期刊论文

  • 发表日期：

    2025年7月26日

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  • Sakshi Shah,
  • Santosh U. P.,
  • Arfan Nasser,
  • Akshay Krishnamurthy

摘要

Background

Thyroid swellings are a common clinical finding, often posing diagnostic challenges in distinguishing benign from malignant nodules. While fine needle aspiration cytology (FNAC) is the gold standard, its limitations necessitate additional tools. This study investigates the utility of thyroid function tests (TFTs), particularly thyroid-stimulating hormone (TSH) levels, in predicting the nature of thyroid swellings.

Methods

This retrospective study included 50 patients aged 12–65 years who underwent thyroid surgery for thyroid swellings at a tertiary care hospital in Karnataka, India. Preoperative TFTs, FNAC findings, and postoperative histopathological examinations were analyzed. TSH levels were categorized into ranges to assess their correlation with histopathological diagnoses. Statistical significance was evaluated using Chi-square and t-tests, with p < 0.05 considered significant.

Results

Among the 50 patients, 12 (24%) had malignant nodules, while 38 (76%) were benign. TSH levels were significantly higher in malignant cases (mean 5.22 µIU/ml) compared to benign cases (mean 2.59 µIU/ml, p < 0.001). Elevated TSH (> 4.5 µIU/ml) was associated with papillary carcinoma in 6 cases, and malignancy was less likely at lower TSH ranges. No significant differences were observed for T3 and T4 levels (p > 0.05). FNAC and histopathology showed partial concordance, with histopathology detecting 12 malignancies compared to 7 by FNAC.

Conclusion

Elevated TSH levels are significantly associated with malignant thyroid nodules, suggesting not only their role as a predictive marker but also as an early indicator for potential malignancy in follow up. Incorporating TSH with FNAC and imaging findings could improve diagnostic accuracy and guide management decisions, minimizing unnecessary interventions.