Association of pre-op TSH levels with Thyroid Carcinoma in a Tertiary Care Setup in Karachi, Pakistan

Abstract

Objectives: This study aimed to explore the relationship between pre-operative TSH levels and the presence of thyroid cancer in patients with nodular thyroid disease in the Pakistani population, using data gathered from patients treated at Dr. Ruth K. M. Pfau Civil Hospital Karachi. Study Design & Setting: A cross-sectional study was conducted at the Dow University of Health Sciences and Dr. Ruth K. M. Pfau Civil Hospital Karachi from January 2022 to December 2022. Methodology: Patients with thyroid swellings (presenting with either solitary nodules or with multinodular goiter), both benign as well as suspected/confirmed malignancy based on FNAC results were recruited in the study. Preoperative TSH levels, along with other clinical data, were collected. Thyroidectomy was carried out in patients fulfilling the criteria for surgery, with specimens sent for histopathology. An independent t-test was used to compare TSH levels between malignant and benign nodules. Results: A total of 82 patients were enrolled. Malignancy was confirmed in 41.5% (25 papillary carcinoma, 9 follicular carcinoma). Significantly higher mean TSH levels were observed in patients with malignant nodules (4.76 IU/mL) compared to those with benign nodules (2.48 IU/mL) (p < 0.001). Conclusion: This study suggests a potential association between elevated pre-operative TSH levels and thyroid cancer in the Pakistani population. These findings warrant further investigation to explore causality and potential underlying mechanisms. The study highlights the value of TSH monitoring, particularly in resource-constrained settings.