Serum Calcitonin May Falsely Estimate Tumor Burden in Chronic Hypercalcemia: A Case of Prostatic and Multiple Bone Metastases from Medullary Thyroid Cancer

Kim, Hee Kyung; Bae, Woo Kyun; Choi, Yoo Duk; Shim, Hyun Jeong; Yoon, Jee Hee; Kang, Ho‐Cheol

doi:10.1089/thy.2013.0121

Cited by 6 publications

(1 citation statement)

References 21 publications

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“…emphasized that preoperative serum calcitonin levels of more than 20, 50, and 200 pg/mL are associated with ipsilateral central and lateral LNM, contralateral central LNM, and contralateral lateral LNM, respectively ( 12 ). However, previous studies have confirmed that preoperative serum calcitonin levels are related to many factors, such as the diameter of the primary tumor and the malignancy of the tumor ( 19 – 21 ). Even when serum calcitonin levels are hundreds of times higher than the upper limit of normal, patients may not benefit from lateral neck dissection.…”

Section: Discussionmentioning

confidence: 99%

A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer

Jin

Zhang²,

Song³

et al. 2022

Front. Endocrinol.

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BackgroundMedullary thyroid cancer (MTC) can only be cured by surgery, but the management of lateral lymph nodes is controversial, especially for patients with cN0+cN1a. To address this challenge, we developed a multivariate logistic regression model to predict lateral lymph node metastases (LNM).MethodsWe retrospectively collected clinical data from 124 consecutive MTC patients who underwent initial surgery at our institution. The data of 82 patients (from 2010 to 2018) and 42 patients (from January 2019 to November 2019) were used as the training set for building the model and as the test set for validating the model, respectively.ResultsIn the training group, the multivariate analyses indicated that male and MTC patients with higher preoperative basal calcitonin levels were more likely to have lateral LNM (P = 0.007 and 0.005, respectively). Multifocal lesions and suspected lateral LNM in preoperative ultrasound (US) were independent risk factors (P = 0.032 and 0.002, respectively). The identified risk factors were incorporated into a multivariate logistic regression model to generate the nomogram, which showed good discrimination (C-index = 0.963, 95% confidence interval [CI]: 0.9286–0.9972). Our model was validated with an excellent result in the test set and even superior to the training set (C-index = 0.964, 95% CI: 0.9121–1.000).ConclusionHigher preoperative basal calcitonin level, male sex, multifocal lesions, and lateral lymph node involvement suspicion on US are risk factors for lateral LNM. Our model and nomogram will objectively and accurately predict lateral LNM in patients with MTC.

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Section: Discussionmentioning

confidence: 99%

A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer

Jin

Zhang²,

Song³

et al. 2022

Front. Endocrinol.

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Calcitonin as Biomarker for the Medullary Thyroid Carcinoma

Bae

Schaab

Kratzsch

2015

Recent Results in Cancer Research

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Calcitonin (CTN) is a polypeptide hormone consisting of 32 amino acids with a disulfide bridge between position 1 and 7 that is mainly produced by the C-cells of thyroid gland. The measurement of CTN concentrations in blood reflects C-cell activity and is performed in general by immunoassay methods. However, there are analytical, physiological, pharmacological, and pathological factors that can influence results of serum CTN values. Due to the influence of these factors, there is a high variability in assay-dependent cutoffs used to discriminate between MTC, C-cell hyperplasia (CCH), and the absence of the pathological impairment of C-cells. There is a lot of evidence that the measurement of serum CTN concentrations in patients with thyroid nodules can lead to an earlier diagnosis of MTC or CCH than the exclusive use of imaging procedures and/or fine-needle aspiration cytology. Basal CTN concentrations higher than 60-100 pg/mL are highly indicative for the diagnosis MTC. In the range between cutoff and 60 pg/mL CTN, both MTC and HCC may be a relevant diagnosis. PCT and CTN appear to have a comparable diagnostic capability to diagnose MTCs. However, "positive" PCT values of more than 50 pg/mL may be reached also in subclinical infections and will lead, therefore, to an overdiagnosis of the tumor. Pentagastrin- or calcium-stimulated serum CTN concentrations higher than cutoff values might improve diagnostics of MTC, but the non-availability of the first and the lacking of relevant cutoff values for the second tool favors the use of only basal values currently.

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Study on the degradation rule of calcitonin in vitro in patients with medullary thyroid carcinoma

Chen

Liu

et al. 2018

Biochemical and Biophysical Research Communications

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Serum Calcitonin May Falsely Estimate Tumor Burden in Chronic Hypercalcemia: A Case of Prostatic and Multiple Bone Metastases from Medullary Thyroid Cancer

Cited by 6 publications

References 21 publications

A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer

A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer

Calcitonin as Biomarker for the Medullary Thyroid Carcinoma

Study on the degradation rule of calcitonin in vitro in patients with medullary thyroid carcinoma

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