Thresholds of Basal- and Calcium-Stimulated Calcitonin for Diagnosis of Thyroid Malignancy
Abstract Since medullary thyroid carcinoma is an aggressive cancer, it is important to have an early detection based on stimulated calcitonin (CT), especially when basal-CT is slightly elevated. The objective of this work was to set specific thresholds for basal-CT- and calcium-stimulated calcitonin...
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Published in | Hormone and metabolic research Vol. 53; no. 12; pp. 779 - 786 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Rüdigerstraße 14, 70469 Stuttgart, Germany
Georg Thieme Verlag KG
01.12.2021
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Subjects | |
Online Access | Get full text |
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Summary: | Abstract
Since medullary thyroid carcinoma is an aggressive cancer, it is important to
have an early detection based on stimulated calcitonin (CT), especially when
basal-CT is slightly elevated. The objective of this work was to set specific
thresholds for basal-CT- and calcium-stimulated calcitonin for prediction of
thyroid malignancy in female population. The study included 2 groups: group
A-women with elevated basal-CT (>9.82 pg/ml) and group
B-women with normal basal-CT (control group). After calcium stimulation test
precise protocol, histopathological reports of those that required surgery were
correlated with both basal and stimulated calcitonin. The best basal and
stimulated calcitonin cut-offs for distinguishing female patients with medullary
thyroid carcinoma or C-Cell-hyperplasia from other pathologies or normal cases
were: 12.9 pg/ml, respectively 285.25 pg/ml. For
basal-CT above 30 pg/ml, malignancy was diagnosed in 9/9
patients (100%): 9 MTC. For stimulated calcitonin above
300 pg/ml, malignancy was diagnosed in 17/21 patients
(80.95%): 12 MTC and 5 papillary thyroid carcinomas. The smallest nodule
that proved to be medullary thyroid carcinoma had only
0.56/0.34/0.44 cm on ultrasound, with no other
sonographic suspicious criteria. In conclusion, we have identified in Romanian
female population basal and stimulated calcitonin thresholds to discriminate
medullary thyroid carcinoma or C-Cell-hyperplasia from other cases. We recommend
thyroid surgery in all women with stimulated calcitonin above
285 pg/ml. Further studies on larger groups are necessary to
establish and confirm male and female cut-offs for early diagnosis of medullary
thyroid carcinoma, and interestingly, maybe for macro-papillary thyroid
carcinomas alike. The calcium administration has minimum side-effects, but
continuous cardiac monitoring is required. |
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ISSN: | 0018-5043 1439-4286 |
DOI: | 10.1055/a-1661-4420 |