Comparison of serum calcitonin and procalcitonin in detecting medullary thyroid carcinoma among patients with thyroid nodules.

Abstract

BACKGROUND:

To prospectively evaluate the role of procalcitonin (PCT) in detecting or excluding medullary thyroid carcinoma (MTC) among patients with thyroid nodules and increased calcitonin (CT) levels.

METHODS:

Fourteen of 1236 patients referred for thyroid nodules had increased serum CT >10 pg/mL. A stimulation test with pentagastrin was done and both CT and PCT were measured after stimulation. All patients underwent thyroid ultrasound, fine-needle cytology and, if indicated, surgery with histological and immunohistochemical examination of the surgical specimens.

RESULTS:

After follow-up, two MTCs were found. These two patients had basal CT >100 pg/mL and detectable (>0.1 ng/mL) PCT, with 100% sensitivity. Pentagastrin stimulated CT achieved values above 100 pg/mL in two MTCs and in other two cases with no MTC outcome (50% PPV and 83% NPV). On the contrary, all patients with no MTC had both basal and stimulated undetectable PCT (100% PPV and 100% NPV).

CONCLUSIONS:

The addition of basal PCT measurement in patients with thyroid nodule(s) and increased CT may significantly improve accuracy of CT measurement without needing a PG stimulation test.

• Authors: Luca Giovanella, Frederik A Verburg, Mauro Imperiali, Stefano Valabrega, Pierpaolo Trimboli, Luca Ceriani
• Journal: Clinical chemistry and laboratory medicine (Clin Chem Lab Med) Vol. 51 Issue 7 Pg. 1477-81 (Jul 2013) ISSN: 1437-4331 [Electronic] Germany
• PMID: 23314540 (Publication Type: Journal Article)

Chemical References

• Biomarkers, Tumor
• CALCA protein, human
• Protein Precursors
• Calcitonin
• Pentagastrin
• Calcitonin Gene-Related Peptide

Topics

• Adult
• Aged
• Biomarkers, Tumor (blood)
• Biopsy, Fine-Needle
• Calcitonin (blood)
• Calcitonin Gene-Related Peptide
• Carcinoma, Neuroendocrine
• Female
• Humans
• Male
• Middle Aged
• Pentagastrin (administration & dosage)
• Predictive Value of Tests
• Protein Precursors (blood)
• Thyroid Gland (diagnostic imaging, pathology)
• Thyroid Neoplasms (blood, diagnosis, diagnostic imaging)
• Thyroid Nodule (blood, diagnosis, diagnostic imaging)
• Ultrasonography