Serum TSH Levels as a Predictor of Malignancy in Thyroid Nodules: a Retrospective Cross-Sectional Analytical Study

Nazrana Farooq; Prof. (Dr.) Shafkat Ahmad Lone; Numaan Qadri

Authors

Nazrana Farooq Senior Resident Department of ENT, Head and Neck Sugery Government Medical College Baramulla.
Prof. (Dr.) Shafkat Ahmad Lone HOD Department of ENT, Head and Neck Sugery Government Medical College Baramulla.
Numaan Qadri PG Scholar Department of ENT, Head and Neck Sugery Government Medical College Baramulla.

Abstract

Background: Thyroid nodules are common endocrine findings, with malignancy reported in 5–15% of cases. Although Fine Needle Aspiration Cytology (FNAC) remains the cornerstone of diagnosis, interest in biochemical predictors such as serum Thyroid Stimulating Hormone (TSH) has increased.

Aim: To evaluate the association between serum TSH levels and malignancy in thyroid nodules in a North Kashmir female cohort.

Methods: A retrospective cross-sectional analysis of 50 consecutive female patients with thyroid nodules undergoing FNAC and preoperative serum TSH estimation was performed. Cytology was classified according to the Bethesda System for Reporting Thyroid Cytopathology. Bethesda V–VI were considered malignant. TSH was analyzed as continuous and categorical (≤2.5 vs >2.5 µIU/mL). Statistical analysis included Student’s t-test and chi-square test.

Results: Mean TSH in malignant cases (n=19) was significantly lower (1.58 µIU/mL) compared to benign/indeterminate cases (3.26 µIU/mL) (p=0.003). TSH ≤2.5 µIU/mL was significantly associated with malignancy (χ²=4.99, p=0.026).

Conclusion: Lower serum TSH levels were significantly associated with malignant thyroid nodules. TSH may serve as an adjunctive biomarker in malignancy risk stratification; however, larger prospective studies are required.