ArticleJournal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale2017
The T4/T3 quotient as a risk factor for differentiated thyroid cancer: a case control study.
Article in Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Sociodemographic and clinical predictors of malignancy in thyroid nodules: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- The associations between thyroid-related hormones and the risk of thyroid cancer: An overall and dose-response meta-analysis.Frontiers in endocrinology · 2022Pooled it
- Malignancy in toxic thyroid adenoma: Revisiting risk assessment and identifying predictors.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Perioperative Thyroid-Metabolic Changes in Pancreatic Ductal Adenocarcinoma According to Surgical Management.Cancers · 2026Article
- The FT4/FT3 ratio combined with thyroglobulin and parathyroid hormone for distinguishing benign from malignant thyroid nodules: a retrospective study based on histopathological diagnosis.Frontiers in medicine · 2026Article
- Explaining Risk Stratification in Differentiated Thyroid Cancer Using SHAP and Machine Learning Approaches.Biomedicines · 2025Article
- Association Between FT4/FT3 Ratio and Short-Term Treatment Response in Differentiated Thyroid Cancer Patients.International journal of endocrinology · 2025Article
- Network toxicological insights into DEHP exposure and thyroid cancer development and progression.Frontiers in oncology · 2025Article
- Can Routine Laboratory Tests Be Suggestive in Determining Suspicions of Malignancy in the Case of Thyroid Nodules?Medicina (Kaunas, Lithuania) · 2023Article
- Can Thyrotropin, Tri-Iodothyronine, and Thyroxine Hormones be Predictors of Cancer in Thyroid Lesions?Cureus · 2022Article
- Adherence to mediterranean diet and the risk of differentiated thyroid cancer in a European cohort: The EPIC study.Frontiers in nutrition · 2022Article
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8 authors.
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Abstract
backgroundThe incidence of thyroid nodules is increasing among patients in North America. Few of these nodules harbour malignancy, thus further research is required to identify predictive markers of malignant thyroid disease. This study set out to understand the relationship between the levels of fT4 and fT3 and differentiated thyroid cancer.
methodsA case-control study was conducted with 142 cases and 86 controls from the McGill University Teaching Hospitals. All patients underwent thyroid surgery. Cases were defined as patients with malignant nodules confirmed on final pathology and controls were defined as patients with benign nodules. The serological levels of TSH, fT4 and fT3 were measured preoperatively. Odds ratios were determined for each parameter and logistic regressions were calculated between markers and probability of malignancy. Additionally, fT4 values were divided by fT3 values (fT4/fT3 quotient) for each patient and an odds ratio was calculated.
resultsAmongst cases, the mean TSH was 2.25 ± 0.360U/mL, fT4 was 14.8 ± 0.689pmol/L, and fT3 was 4.65 ± 0.463pmol/L. Amongst controls, the mean TSH was 2.36 ± 1.68U/mL, fT4 was 14.3 ± 1.71pmol/L, and fT3 was 5.27 ± 0.957pmol/L. Patients in the control group were more likely to have low TSH, while patients in the case group would have high fT4 and patients in the control group were more likely to have a low fT4. The OR for patients with TSH >4.4U/mL was 2.13 (0.97, 4.65), and for patients with TSH <0.4U/mL was 0.46 (0.22, 0.95). The OR for patients with fT4 > 16pmol/L was 2.10 (1.09, 4.06), and for patients with fT4 < 10pmol/L was 0.45 (0.20, 0.98). The OR for patients with fT3 > 5.5pmol/L was 0.39 (0.14, 1.28). The OR for patients with fT3 < 3pmol/L was 1.83 (0.25, 13.69). The average fT4/fT3 was 3.39 ± 0.206 for cases and 2.93 ± 0.467 for controls. The fT4/fT3 quotient was considered high if it was >3.3 (OR =6.00 (2.94, 12.25)).
conclusionIn this study, a direct relationship between high levels of fT4 and malignancy was uncovered. Furthermore, low levels of TSH and fT4 increased the likelihood that a nodule was benign. In this study a fT4/fT3 ratio >3.3 increased the risk of malignancy by 3.6 times (p-value =0.0013).
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