RELAÇÃO DOS NÍVEIS DO HORMÔNIO ESTIMULANTE DA TIREÓIDE (TSH) COM A MALIGINIDADE DOS NÓDULOS DE TIREÓIDE
Palavras-chave:
nódulo de tireóide, câncer de tireóide, hôrmonio estimulante da Tireoide (TSH)Resumo
Introdução: associação entre os níveis elevados de TSH como fator trófico á célula tireoidiana e a maior prevalência de cânce tireoidiano tem sido discutida.
Objetivos: Relacionar os Níveis de TSH em Valores de Corte, conforme a literatura, com a malignidade em nódulos de tireóide (NT).
Material e métodos: Estudo tranversal de 159 prontuários ( 171NT) no HU/UFSC de agosto de 2010-2012. Realizadas avaliações cito-patológicas e do TSH em ensaio de quimiluminescência( terceira geração) á época da punção aspirativa e categorizando os pontos de corte. Pacientes com disfunçaõ estabelecida foram excluídos. Análises estatistícas com teste do X2 e Fischer e significância em p< 0,05.
Resultados: A média de idade dos pacientes foi de 48 anos com 92,4% de mulheres; 2,9% , 64,3% , 5,3%, 10,5%, 8,8% e 8,2% dos NT com Bethesda 1a VI respectivamente. O TSH variou de 0,08 a 10,5 ( média: 1,965 ± 1,69; mediana: 1,48) uUI/mL. Trinta e cindo NT foram operados, sendo 74,3% malignos e, deses, 80,8% carcinomas papilíferos. Análises dos grupamentos Bethesda e citopatológicos ( casos operados + não operados com citopatologias II, V, VI = 150 NT) em valores de corte de TSH< 1 e ? 1, TSH < 1,8 e ? 1,8 uUI/mL .Evidenciaram significância apenas em 1,8, com 32,7% dos NT Bethesda II e 71,4 % dos Bethesda VI ? 1,8 . Confirmando-se a Histopatologia onde 33,9%de 115 NT Benignos versus 60% de 35 NT Malignos apresentavam TSH? 1,8 uUI/mL(p<0,006).
Conclusão: Malignidade em NT relacionou-se com valro de corte de TSH? 1,8 uUI/mL.
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