A cut‐off value of basal serum calcitonin for detecting macroscopic medullary thyroid carcinoma. (1st September 2014)

• Record Type: Journal Article
• Authors: Kwon, Hyemi; Kim, Won Gu; Choi, Yun Mi; Jang, Eun Kyung; Jeon, Min Ji; Song, Dong Eun; Baek, Jung Hwan; Ryu, Jin‐Sook; Hong, Suck Joon; Kim, Tae Yong; Kim, Won Bae; Shong, Young Kee
• Is Part Of: Clinical endocrinology. Volume 82:Number 4(2015:Apr.)
• Page Start: 598
• Page End: 603
• Publication Date: 2014-09-01
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12562
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12562-abs-0001"> <title>Summary</title> <sec id="cen12562-sec-0001" sec-type="section"> <title>Objective</title> <p>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.</p> </sec> <sec id="cen12562-sec-0002" sec-type="section"> <title>Design and patients</title> <p>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 Asan Medical Center. We divided patients into four groups: proven MTC (group 1, <italic>n </italic>=<italic> </italic>93), pathologically proven non‐MTC after surgery (group 2, <italic>n </italic>=<italic> </italic>57), benign single nodule by cytology (group 3, <italic>n </italic>=<italic> </italic>68) and patients without nodules on US (group 4, <italic>n = </italic>24).</p> </sec> <sec id="cen12562-sec-0003" sec-type="section"> <title>Measurement</title> <p>Basal serum CT levels were evaluated.</p> </sec> <sec id="cen12562-sec-0004" sec-type="section"> <title>Results</title> <p>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, <italic>P </italic><<italic> </italic>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.</p> </sec> <sec id="cen12562-sec-0005" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>