Relationship between the serum level of thyrotropin,auto-antibodies and the nature of thyroid nodules

【Objective】To discuss the feasibility and value of predicting differential diagnosis of benign and malignant thyroid nodules by laboratory examination before operation.【Methods】The records of 1 243 patients who underwent thyroidectomy for nodular thyroid disease were analyzed retrospectively.The relationship between pathological diagnosis and the results of laboratory test of TSH,TgAb/TPOAb and the ultrasonographic parameters were examined.【Results】Ratios of elevating serum level of TSH and TgAb/TPOAb were higher in malignant groups than benign groups(7.0% vs 3.1%,42.6% vs 30.1%).Ratios of malignant nodules were higher in groups with elevating TSH and TgAb/TPOAb than non-elevating groups(33.3% vs 16.9%,25.6% vs 16.6%).Among the carcinoma patients,ratios of multifocal thyroid carcinoma were higher in TSH and TgAb/TPOAb elevating groups than non-elevating groups(69.2% vs 16.7%,30.2% vs 2.9%),so as the level of tumor invasion.The specificity and accuracy of malignant diagnosis by elevation of TSH and TgAb/TPOAb were 96.9%,82.1% and 70.0%,64.7%,respectively.【Conclusion】Elevations of serum TSH and TgAb/TPOAb before operation are danger indicators for malignant thyroid nodules,and they are related to multifocal thyroid carcinoma and the level of tumor invasion.