Journal Information
Journal ID (publisher-id): BM
Journal ID (nlm-ta): Biochem Med (Zagreb)
Title: Biochemia Medica
Abbreviated Title: Biochem. Med. (Zagreb)
ISSN (print): 1330-0962
ISSN (electronic): 1846-7482
Publisher: Croatian Society of Medical Biochemistry and Laboratory Medicine
Article Information
Copyright statement: Copyright Croatian Society of Medical Biochemistry and Laboratory Medicine
Copyright: 2018, Copyright Croatian Society of Medical Biochemistry and Laboratory Medicine
License (http://creativecommons.org/licenses/by/4.0/):
This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY) 4.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Date received: 18 April 2018
Date accepted: 20 August 2018
Publication date (print and electronic): 15 October 2018
Volume: 28
Issue: 3
Electronic Location Identifier: 030710
Publisher ID: bm-28-3-030710
DOI: 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”
Christian Scheuba[1]
Alois Gessl[3]
Shuren Li[4]
Oskar Koperek[5]
Christian Bieglmayer[6]
Philipp Riss[1]
Andreas Selberherr[1]
[1] Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
[2] Division of General Anesthesia and Intensive Care Medicine, Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
[3] Division of Endocrinology and Metabolism, Third Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
[4] Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
[5] Department of Pathology, Medical University of Vienna, Vienna, Austria
[6] Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
[7] Former Chief of the Section “Endocrine Surgery”, Department of Surgery, Medical University of Vienna, Vienna, Austria
Author notes:
[*] Corresponding author: martin.niederle@meduniwien.ac.at
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%).
Keywords: medullary thyroid cancer; thyroid; calcitonin; calcium gluconate; pentagastrin
