J Med Sci, Volume 51, Number 4, 2019 October: 340-350 340 *corresponding author: djoriant@ugm.ac.id Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Volume 51, Number 4, 2019; 340-350 http://dx.doi.org/10.19106/JMedSci005104201908 Submited: 2019-04-22 Accepted : 2019-08-31 Keywords: thyroid stimulating homone thyroid carcinoma early stage advance stage predictor The role of thyroid stimulating hormone level as a predictive factor for advance stage thyroid carcinoma Bambang Udji Djoko Rianto*, Anton Sony Wibowo, Camelia Herdini Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta ABSTRACT Thyroid stimulating hormone (TSH) is a cancer growth stimulus factor that have effect on the progression of thyroid carcinoma, common neck head malignancy. This hormonelevel has diagnostic value and can assist in the diagnosis, staging and management of the thyroid carcinoma. This study aimed to investigatethe role of TSH level as a predictor of advance stage thyroid carcinoma. This was case-control study involvingthyroid enlargement subjects who underwent thyroidectomy at Dr. Sardjito General Hospital, Yogyakarta from 2015 to 2017. Cancer staging examination using AJCC 2102 and TSH levels examination were conducted before underwent thyroidectomy. The inclusion criteria for case group were advanced stage (stage III and IV), while for control group wereearly- stage of thyroid carcinoma (stage I and II). The exclusion criteria for both case and control groups were 1) suffering from thyroid hormone disorders requiring therapy before thyroidectomy, 2) receiving thyroid suppression therapy prior to thyroidectomy. Sixty-six post thyroidectomy patients were involved in this study. The patients were divided into case and control groups consisted of 33 patients in each group. Based on receiver operating characteristic curve, the cut of point 1.27 mIU/L for TSH was obtained with sensitivity of 72.7% and specificity of 78.8%. There was statistically significant difference TSH levels between early stage thyroid carcinoma and late stage thyroid carcinoma (p = 0.001;OR: 9.9;95% CI: 3.19-30.15). It can be concluded that TSHlevels ≥ 1.27mIU/L as predictor of advance stage thyroid carcinoma. ABSTRAK Hormon perangsang tiroid (thyroid stimulating hormone/TSH) adalah faktor stimulus pertumbuhan kanker yang berpengaruh terhadapp progresivitas kanker tiroid, keganasan kepala leher yang sering terjadi. Nilai kadar hormon ini penting dalam membantu penegakan diagnosis, penentuan stadium dan tatalaksana karsinoma tiroid. Tujuan penelitian ini adalah mengkaji peran kadar TSH sebagai prediktor karsinoma tiroid stadium lanjut. Penelitian ini merupakan penelitian potong lintang yang melibatkan pasien karsinoma tiroid yang menjalani operasi tiroidektomi di RSUP Dr. Sardjito, Yogyakarta dari tahun 2015 sampai 2017. Pemeriksaan stadium karsioma dengan AJCC 2012 dan pemeriksaan kadar TSH dilakukan sebelum menjalani tiroidektomi. Kriteria inklusi kelompok kasus adalah karsinoma tiroid stadium lanjut (stadium III dan IV), sedangkan kelompok kontrol adalah stadium awal (I dan II). Kriteria eksklusi kedua kelompok kasus dan kontrol adalah 1) menderita gangguan hormon tiroid yang membutuhkan terapi sebelum tiroidektomi, 2) menerima terapi penekanan tiroid sebelum tiroidektomi. Enam puluh enam pasien pasca tiroidektomi terlibat dalam penelitian. Pasien dibagi menjadi kelompok kasus dan kontrol dengan setiap kelompok 33 pasien. Berdasarkan receiver operating characteristic curve, diperoleh nilai ambang batas kadar TSH 1,27 mIU/L dengan sensitivitas 72,7% dan spesivisitas 78,8%. Terdapat perbedaan nyata kadar TSH antara karsinoma tiroid stadium awal dan karsinoma tiroid stadium akhir (p = 0,001; OR: 9,9; 95% CI: 3,19-30,15). Dapat disimpulkan bahwa kadar TSH ≥ 1.27mIU/L merupakan prediktor karsinoma tiroid stadium lanjut.