Relationship between postoperative serum thyroid-stimulating hormone concentration and recurrence of nodular goiter in Changji Hui autonomous prefecture of Xinjiang

Abstract:

Objective：To study of relationship between postoperative serum thyroid-stimulating hormone（TSH） concentration and re－currence of nodular goiter in Changji Hui autonomous prefecture of Xinjiang and its influencing factors and to further investigate the appropriate level of serum TSH suppression after nodular goiter operation. Methods：Retrospective analysis was made on 781 cases of nodular goiter in People’s Hospital of Changji Hui Autonomous Prefecture. Number of cases within different serum TSH values was counted based on different genders，ages，maximum nodule diameters，nodule numbers and operation modes. Differences in recurrence rates were statistically analyzed. Results：Concentration of serum TSH was significantly higher in those with nodular goiter recurrence than in those without recurrence（3.21±1.34） mIU/L vs. （1.09±0.63） mIU/L（t=20.344 9，P=0.000 0）. With the reduction of postop－erative serum TSH level，recurrence rate in patients with nodular goiter was gradually reduced. But when serum TSH level was reduced to less than 1.0 mIU/L，recurrence rate was no longer declined. When postoperative serum TSH level was lower than 4.5 mIU/L，the larger the thyroidectomy ranges，the lower the recurrence rates. When serum TSH concentration was higher than 4.5 mIU/L，recurrence rate was lower in subtotal thyroidectomy group than in partial thyroidectomy group and lobectomy+isthmusectomies group，with no sig－nificant difference in recurrence rate between the latter two groups（ χ2=0.000，P=1.000）. Conclusions：Excising enough thyroid and suppressing TSH to less than 1.0 mIU/L can maximally prevent the recurrence and minimize the adverse effects due to the application of levothyroxine.