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Calcitonin precursor levels in human medullary thyroid carcinoma.

AbstractDESIGN:
The hormonal serum marker for the presence and course of patients with medullary thyroid cancer (MTC) is the mature calcitonin (CT) peptide. Other CALC-1 gene products such as the 116-amino acid polypeptide prohormone, procalcitonin, as well as its component calcitonin precursors (CTpr) may also be increased in their sera. We performed a study to evaluate the clinical utility of serum levels CTpr in these patients.
METHODS:
Twenty-one patients with MTC (9 males, 12 females; 23-76 years of age) were evaluated. The diagnosis was confirmed by histologic examination, except for 2 (a proven RET mutation plus an abnormal pentagastrin-stimulated CT level). Nine patients had postoperative hypercalcitoninemia and 3 of these died. The specific assay for mature CT was a commercial immunoradiometric assay (hCT-IRMA); the immunoluminometric assay for CTpr (B.R.A.H.M.S Diagnostica, Berlin, Germany) detects intact procalcitonin and the free CT:CT carboxypeptide-1.
RESULTS:
All patients had detectable serum CTpr. These levels considerably exceeded those of mature CT, averaging 7.6-fold greater. CTpr levels correlated positively with mature CT (r = 0.61; p < 0.001). After pentagastrin administration, there was a parallelism of response between the two assays. Whenever there were known metastases, CTpr increased markedly.
CONCLUSION:
This study demonstrates the universal presence of CTpr in the blood of patients with MTC. The measurement of these peptides may offer a new dimension to the clinical evaluation of this malignancy.
AuthorsH Bihan, K L Becker, R H Snider, E Nylen, L Vittaz, C Lauret, E Modigliani, J L Moretti, R Cohen
JournalThyroid : official journal of the American Thyroid Association (Thyroid) Vol. 13 Issue 8 Pg. 819-22 (Aug 2003) ISSN: 1050-7256 [Print] United States
PMID14558925 (Publication Type: Journal Article)
Chemical References
  • Biomarkers, Tumor
  • Oncogene Proteins
  • Protein Precursors
  • procalcitonin
  • Calcitonin
  • Proto-Oncogene Proteins c-ret
  • RET protein, human
  • Receptor Protein-Tyrosine Kinases
Topics
  • Biomarkers, Tumor (blood)
  • Calcitonin (blood)
  • Humans
  • Oncogene Proteins (genetics)
  • Prognosis
  • Protein Precursors (blood)
  • Proto-Oncogene Proteins c-ret
  • Receptor Protein-Tyrosine Kinases (genetics)
  • Reference Values
  • Retrospective Studies
  • Thyroid Neoplasms (blood, diagnosis, genetics)

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