Izvorni znanstveni članak

https://doi.org/10.11613/BM.2018.030710

Calcium-stimulated calcitonin - The “new standard” in the diagnosis of thyroid C-cell disease - clinically relevant gender-specific cut-off levels for an “old test”

Martin B. Niederle orcid.org/0000-0003-0450-6132 ; Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria; Division of General Anesthesia and Intensive Care Medicine, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienn
Christian Scheuba ; Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
Alois Gessl ; Division of Endocrinology and Metabolism, Third Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
Shuren Li ; Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
Oskar Koperek ; Department of Pathology, Medical University of Vienna, Vienna, Austria
Christian Bieglmayer ; Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
Philipp Riss
Andreas Selberherr ; Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
Bruno Niederle ; Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria; Former Chief of the Section “Endocrine Surgery”, Department of Surgery, Medical University of Vienna, Vienna, Austria

Sažetak

Introduction: Pentagastrin (Pg) stimulated calcitonin (sCT) was used to enhance accuracy in medullary thyroid cancer (MTC) diagnosis. As it is now
unavailable, calcium (Ca) has been recommended as an alternative. The aim of this study was to define gender-specific cut-off values to predict MTC
in patients with elevated basal CT (bCT) following Pg-sCT and Ca-sCT stimulation and to compare the time courses of CT release during stimulation.
Materials and methods: The stimulation tests were applied in 62 consecutive patients with thyroid nodules. Basal calcitonin was measured by
chemiluminescent immunometric assay. All patients underwent thyroidectomy and bilateral central neck dissection. C-cell pathology was confirmed
by histological and immunohistochemical evaluation.
Results: In 39 (0.63) patients MTC was documented while isolated C-cell hyperplasia (CCH) was identified in 23 (0.37) patients. Medullary thyroid
cancer was predicted in males with bCT values > 43 pg/mL or sCT concentrations > 470 pg/mL (Pg-sCT) or > 1500 pg/mL (Ca-sCT), and in females
with bCT concentrations > 23 pg/mL or sCT concentrations > 200 pg/mL (Pg-sCT) or > 780 pg/mL (Ca-sCT), respectively. Pg-sCT correctly predicted
MTC in 16 (0.66) compared to 13 (0.54) after Ca-sCT in males and in 12 (0.80) compared to 11 (0.73) in females; without statistical significance. In
patients with CCH or low tumor burden, there was a tendency of faster CT release after Ca stimulation (CT peak after 3min in > 60%) compared to
patients with advanced MTC (CT peak after 3min in < 10%).
Conclusions: Using gender-specific cut-off values, Ca could replace Pg to predict MTC with similar diagnostic power.

Ključne riječi

medullary thyroid cancer; thyroid; calcitonin; calcium gluconate; pentagastrin

Hrčak ID:

206662

URI

https://hrcak.srce.hr/206662

Datum izdavanja:

15.10.2018.

Posjeta: 767 *