In:
Clinical Endocrinology, Wiley, Vol. 82, No. 4 ( 2015-04), p. 598-603
Kurzfassung:
Serum calcitonin ( CT ) level is used to detect medullary thyroid carcinoma ( MTC ), but the cut‐off level is unclear. We aimed at identifying the optimal cut‐off value of basal serum CT levels for detecting MTC . Design and patients We retrospectively enrolled patients with hypercalcitoninemia (≥2·9 pmol/l) who had undergone thyroid ultrasonography ( US ) and subsequent work‐up between 2001 and 2013 at A san M edical C enter. We divided patients into four groups: proven MTC (group 1, n = 93), pathologically proven non‐ MTC after surgery (group 2, n = 57), benign single nodule by cytology (group 3, n = 68) and patients without nodules on US (group 4, n = 24). Measurement Basal serum CT levels were evaluated. Results The median CT level of group 1 (119·5 pmol/l) was significantly higher than those of other groups (4·0, 3·8 and 3·8 pmol/l, P 〈 0·001). When we adopted 19·0 pmol/l of CT level as a cut‐off value, the sensitivity, specificity, and positive and negative predictive values were 77·4%, 98·7%, 97·3% and 87·8%, respectively. When we compared 29·2 pmol/l (100 pg/ml) and 19·0 pmol/l (65 pg/ml) as cut‐off values, 19·0 pmol/l was more sensitive and accurate than 29·2 pmol/l. Factors associated with hypercalcitoninemia in non‐ MTC groups were autoimmune thyroiditis, chronic kidney disease, proton pump inhibitors and other malignancies. Serum CT levels tended to decrease spontaneously in non‐ MTC groups. Conclusion Basal serum CT levels higher than 19·0 pmol/l can be a useful cut‐off value for detecting macroscopic MTC , even though values below 19·0 pmol/l cannot exclude the presence of MTC like small volume MTC or premalignant C ‐cell hyperplasia.
Materialart:
Online-Ressource
ISSN:
0300-0664
,
1365-2265
DOI:
10.1111/cen.2015.82.issue-4
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2015
ZDB Id:
2004597-9
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