Calcium Stimulated Calcitonin Measurement: A Procedural Proposal

Verburg, F. A.; Reiners, Christoph; Grelle, I.; Barth, Holger; Fassnacht, Martin; Luster, Markus

doi:10.1055/s-0033-1333686

Cited by 9 publications

(5 citation statements)

References 5 publications

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“…Most data in the past have shown that the positive predictive value of measuring basal CT for the diagnosis of MTC is lower than for stimulated CT [19]. In contrast, Mian et al [23] indicated that bCT values are at least as good predictors for MTC as stimulated CT values and suggested that bCT assays with improved functional sensitivity may avoid the stimulation test in several conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, pentagastrin is not available any longer. An alternative method represents the calcium stimulation test, being described as sensitive as well, however, also having side effects [18,19]. Nevertheless, due to the (partly life-threatening) adverse effects [20][21][22] of this stimulation test and due to the not yet well defined cut-offs for the calcium stimulation test [20,23,24], bCT levels are gaining in importance.…”

Section: Introductionmentioning

confidence: 99%

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Measurement of Basal Serum Calcitonin for the Diagnosis of Medullary Thyroid Cancer

et al. 2017

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Calcitonin (CT), a tumor marker for medullary thyroid cancer (MTC), can be stimulated with pentagastrin or calcium. Because of the unavailability of pentagastrin, basal CT measurement is frequently used for the preoperative diagnosis of MTC. The aim of the study was to define basal serum calcitonin (bCT) cut-off thresholds for diagnosing MTC. Within a retrospective analysis, 114 patients (51 males) were included fulfilling the criteria of an increased preoperative bCT level (>10 pg/ml) and the criteria of an available postoperative histology analysis. Based on a ROC plot analysis, the cut-off values for the diagnosis of MTC vs. non-malignancy (C cell hyperplasia and goiter) were identified. The most precise bCT thresholds for the identification of MTC were ≥46 pg/ml for males (sensitivity: 93.6%, specificity: 95.0%, PPV: 97%, NPV: 90%) and ≥35 pg/ml for females (sensitivity: 87.3%, specificity: 87.5%, PPV: 98%, NPV: 50%). Using these cut-offs, only 6% of male patients were not identified of having MTC, whereas 5% were false positive (having instead C cell hyperplasia). In females, the discrepancy was higher since 13% of female MTC patients were false negative by using the cut-off of ≥35 pg/ml, and 13% had false positive results (suffering from C cell hyperplasia). Gender-specific bCT cut-offs for the identification of MTC vs. C cell hyperplasia and non-malignancy were defined, which can be used in clinical routine. In female patients, however, the accuracy is much lower compared to males.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Measurement of Basal Serum Calcitonin for the Diagnosis of Medullary Thyroid Cancer

et al. 2017

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“…In the German Association of Endocrine Surgeons practice guidelines for the surgical management of malignant thyroid tumors [ 43 ], total thyroidectomy is generally warranted if stimulated calcitonin serum levels are higher than 100 pg/mL in adults since the risk of MTC is considered to be substantial if this cut-off value is exceeded. Since 2010/2011, pentagastrin has become increasingly difficult to obtain/has not been available, and the Thyroid Section of the DGE initially suggested a return to the calcium gluconate test [ 8 ] which had already been used since the 1970s.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, since 2010/2011, pentagastrin is no longer approved or is no longer available as a stimulant for the differential diagnosis of equivocal (only moderate—up to about 50 pg/mL) basal Ctn elevations. Alternatively, the calcium stimulation test was suggested [ 7 , 8 , 9 ]. Yet, this test can also lead to false-positive results—for example in the case of papillary thyroid carcinomas (PTC) [ 10 , 11 ]—and its advantage of over-optimized basal Ctn threshold values has increasingly been questioned in recent years [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Update on Calcitonin Screening for Medullary Thyroid Carcinoma and the Results of a Retrospective Analysis of 12,984 Patients with Thyroid Nodules

Broecker-Preuß

Simon²,

Fries

et al. 2023

Cancers

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Background: We provide an update on calcitonin (Ctn) screening for the early detection of medullary thyroid carcinoma (MTC) and present the results of a large single-center analysis evaluating sex-specific cut-off-levels and long-term courses. Methods: A total of 12,984 consecutive adult patients (20.1% male and 79.9% female) with thyroid nodules who had undergone routine Ctn measurement were retrospectively analyzed. Patients with confirmed suspicious Ctn values were referred for surgery. Results: Ctn measurements were elevated in 207 (1.6%) patients, with values below twice the sex-specific reference limit in 82% of these cases. Further clarification was possible in 124/207 cases, of which MTC could be ruled out in 108 cases. Histopathological assessment confirmed MTC in 16/12,984 patients. Conclusions: Our extrapolated MTC prevalence of 0.14% is significantly lower than that described in early international screening studies. The stimulation test can usually be dispensable when using a decision-making concept based on sex-specific basal Ctn cut-off values. Ctn screening is recommended even in patients with very small thyroid nodules. High quality standards in pre-analytics, laboratory measurements, and the interpretation of data must be ensured, as well as close interdisciplinary cooperation between medical disciplines.

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“…Кальцитонін відповідає в організмі за зниження рівня кальцію, а його біологічне значення в кальцієвому гомеостазі не дуже значне. Проте він може виступати онкомаркером медулярного раку щитоподібної залози, який розвивається у парафолікулярних клітинах і продукує кальцитонін (Verburg et al, 2013). На відміну від кальцитоніну, інтактний паратгормон підвищує рівень кальцію в організмі.…”

Section: рис 7 вміст інтактного паратгормону в крові чоловіківunclassified

The thyroid status of a conditionally healthy adult population of Prydniprovia

Arzhanov

Бунятов

Ушакова

2017

Regul. Mech. Biosyst.

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Pathologies of the thyroid gland are one of the most common diseases in endocrinology today. Hormones of the thyroid gland carry out hormonal regulation of the cell cycle, the physiological and post-traumatic repair of cells. The hormones of the thyroid gland secrete and enhance the oxidative processes and control the heat production, which can affect the mental state and the ability of the body to adapt to adverse environmental factors. In the case of a lack or almost complete absence of thyroid hormones, normal development and function of any functional system in the body is not possible. In the context of an increase in the incidence of thyroid gland pathology inUkraine, this article presents an analysis of the thyroid status of the conditionally healthy population of Prydniprovia, related to age and gender. For the study, 120 patients of both sexes aged between 20 to 70 were selected. All patients were divided into 3 age groups of 40 people. Each age group was divided into 2 subgroups – male and female, with 20 people in each subgroup. Patients who, in the past and during the experiment, had no cases of thyroid gland disease were selected for accurate and reliable results. The study of thyroid status of the population showed that most of the adult and healthy population of Prydniprovia was not severely affected. All indicators were included in the age and gender limits of the norm, which are established by the preanalytical requirements of the independent laboratory Invitro (Dnipro,Ukraine). In women aged 50–70 years, there is an increased risk of hypothyroidism, which is confirmed by low levels of free thyroxine and triiodothyronine in the blood against the background of increased thyroid stimulating hormone and thyroglobulin levels. In the adult, conditionally healthy population of the Dnipro region aged between 20–70 years, the following correlation relations were observed between thyroid stimulating and thyroid hormones: at a younger age for men, the relationship between TSH and fT4 was –0.97, for TSH and fT3 –0.96, women also had a negative interdependence between these hormones (–0.95 and -0.98 respectively). The age of the men who underwent the test did not change this dependence but in women after 50 years, the Pearson correlation coefficient decreased between the studied hormones TTG and fT4 and fТ3 to –0.94 and –0.93, respectively. Indicators of total thyroxine and total triiodothyronine in the blood serum are not indicative for determining the risk of hypothyroidism.

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Calcium Stimulated Calcitonin Measurement: A Procedural Proposal

Cited by 9 publications

References 5 publications

Measurement of Basal Serum Calcitonin for the Diagnosis of Medullary Thyroid Cancer

Measurement of Basal Serum Calcitonin for the Diagnosis of Medullary Thyroid Cancer

Update on Calcitonin Screening for Medullary Thyroid Carcinoma and the Results of a Retrospective Analysis of 12,984 Patients with Thyroid Nodules

The thyroid status of a conditionally healthy adult population of Prydniprovia

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