Medullary Thyroid Carcinoma Preferentially Secreting Procalcitonin

João, BugalhoMaria; Madureira, Deolinda; Domingues, Rita; PereiraTeresa,; CortezLuísa,

doi:10.1089/thy.2013.0664

Cited by 4 publications

(3 citation statements)

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“…This last setting represents a real challenge in clinical practice: the most part of MTC patients have negative imaging for years, in spite of recurrent and useful clinical, biochemical, and radiological assessments. Moreover, MTC can also lose its ability to secrete Ct during the follow-up in rare cases and clinical settings ( 21 , 25 ). So, we decided to evaluate the ProCt performance in the follow-up of MTC, in a quite large and monocentric series, with the aim to explore the possibility that such a marker could be of help in identifying patients at risk of structural disease.…”

Section: Discussionmentioning

confidence: 99%

“…This behavior can have various explanations. Indeed, MTC that preferentially secrete ProCt instead of Ct due to a defective prohormone processing are possible, with anecdotal cases being described in literature, at diagnosis and in recurrent and metastatic MTCs ( 21 , 25 ). Moreover, in vitro studies have demonstrated that RNA processing of Ct and ProCt vary during the different stages of growth, with a low Ct expression (and thus a higher proportion of precursors), especially during rapid growth ( 28 , 29 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

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The role of procalcitonin in the follow-up of medullary thyroid cancer

Censi

Manso

Benvenuti

et al. 2023

European Thyroid Journal

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Objective: Calcitonin (Ct) represents the most important biochemical marker of medullary thyroid cancer (MTC), but has certain limits. We analysed the performance of Procalcitonin (ProCt) in follow-up MTC patients. Methods: in this monocentric and retrospective study we consecutively obtained ProCt and Ct values from all MTC patients that we visited during the period from April 2021 to May 2022. Patients were defined as having a structural evidence of disease (29/90, 32.2%) irrespective of Ct values or, in its absence, as not evident disease (NED) if Ct was ≤10 ng/L (47/90, 52.2%), or minimal residual disease, if Ct was >10 ng/L (14/90, 15.6%). Results: Ct and ProCt values were highly correlated (r=0.883, P<0.01). Median ProCt values differed between NED, minimal residual disease and structural disease, being 0.04 ng/ml, 0.26 ng/ and 1.98 ng/ml, respectively (P<0.01). ProCt was undetectable (<0.04 ng/ml) in 40/47 (85.1%) of NED patients, in 3/14 (21.4%) patients with a minimal residual disease and in none of the patients with a structural disease (P<0.01). Among the 11 patients with detectable but ≤10 ng/L Ct and undetectable ProCt values, none had a structural disease. The most accurate cut-off of ProCt to distinguish between presence or absence of a structural disease was >0.12 ng/ml (P<0.01, AUC: 0.963), with the following sensitivity, specificity, positive predictive value and negative predictive value (NPV): 100%, 83.61%, 74.4% and 100.0%. Conclusions: ProCt and Ct have a high correlation in MTC follow-up. ProCt may be useful as an adjunct to Ct especially for its NPV concerning structural disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The role of procalcitonin in the follow-up of medullary thyroid cancer

Censi

Manso

Benvenuti

et al. 2023

European Thyroid Journal

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“…Brutsaert et al (2015) tested ProCT levels of one patient before and after surgery: its value converted from detectable (0.21 ng/ml) to undetectable (!0.1 ng/ml) respectively. Bugalho et al (2014) described a man with recurrent MTC with liver metastasis of 34 mm, a low CT value (!50 ng/ml), and a high ProCT value (10.1 ng/ml). These reports should receive attention specifically because they could help with the management, before and after surgery, of those MTC cases with negative/undetectable CT (Trimboli & Giovanella 2015).…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin for detecting medullary thyroid carcinoma: a systematic review

Trimboli¹,

Seregni²,

Treglia³

et al. 2015

Endocrine-Related Cancer

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The aim of the present study was to perform a systematic review of published studies to provide a robust estimation of the use of procalcitonin (ProCT) as a diagnostic marker of medullary thyroid carcinoma (MTC), with particular focus on its specificity and negative predictive value in excluding MTC. A comprehensive computer literature search was conducted to find relevant published articles on the topic. We used a search algorithm based on a combination of the terms 'medullary,' 'thyroid,' and 'ProCT.' The search was updated until February 2015. To expand our search, references of the retrieved articles were also screened. A total of 39 articles were retrieved, of which nine original papers published from 2003 to 2014 were selected for the review. Some of these studies used ProCT in the preoperative diagnosis of MTC, whereas others measured ProCT during the follow-up of patients who had been previously treated for MTC. Other laboratory measurements were performed in some of the included studies. The results of the majority of the studies indicate that ProCT measurement appears to be a very promising and reliable serum marker for the diagnosis of MTC, and it is not inferior to calcitonin (CT). The sample handling is less laborious, and in the few CT-negative cases reviewed, the assay had even greater sensitivity. It would be worthwhile to establish cutoff levels using larger patient series, because we speculate that this assay could potentially replace CT measurement in the future.

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