Document Detail

Calcitonin screening and pentagastrin testing: predictive value for the diagnosis of medullary carcinoma in nodular thyroid disease.
MedLine Citation:
PMID:  20332126     Owner:  NLM     Status:  MEDLINE    
CONTEXT: Serum calcitonin (hCT) measurement may be useful for detecting medullary thyroid carcinoma (MTC), but the routine use of hCT after pentagastrin stimulation to screen patients with nodular thyroid disease remains controversial. PATIENTS: A total of 1007 patients (567 females and 440 males) with nodular thyroid disease and a mean age of 55+/-14 (mean+/-S.D.) years were included in the study. All patients did not have impaired renal function, bacterial infection, alcohol and drug abuse, pseudohypoparathyroidism, or proton-pump inhibitor therapy. Individuals referred with known elevation of hCT, Graves' disease, or autoimmune thyroid disease were not considered or included in this investigation. METHODS: Serum hCT levels were determined under basal conditions, and when basal values were >or=10 and <100 pg/ml, testing was repeated after pentagastrin stimulation. Patients with basal or stimulated levels >100 pg/ml were referred for surgery. RESULTS: hCT levels >10 pg/ml were increased in 17 patients (1.7%). One patient had a basal hCT level of 4400 pg/ml with a histological confirmation of a MTC. In this patient, pentagastrin test was not performed. Sixteen patients with basal hCT between 10 and 100 pg/ml underwent pentagastrin-stimulated hCT measurement. Of 16 patients, 4 had stimulated hCT>100 pg/ml. Of 17 patients with hCT>10 pg/ml, 2 had MTC, and of 17 patients, 3 had C-cell hyperplasia. In total, two patients (0.20%) had a histologically verified MTC. CONCLUSIONS: Basal hCT measurement together with pentagastrin-stimulated hCT measurement in cases of basal hCT>10 pg/ml detects MTC in 0.20% of patients with nodular thyroid disease. Whether this high incidence of MTC has major implications or not has to be discussed, but it should be considered as a useful and recommended tool for early detection of MTC and to save patients' life.
B L Herrmann; K W Schmid; R Goerges; M Kemen; K Mann
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Publication Detail:
Type:  Journal Article     Date:  2010-03-23
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  162     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1141-5     Citation Subset:  IM    
Department of Endocrinology and Division of Laboratory Research, University Duisburg-Essen, Essen, Germany.
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MeSH Terms
Calcitonin / blood*
Carcinoma, Medullary / blood,  complications,  diagnosis*
Middle Aged
Pentagastrin / diagnostic use*
Predictive Value of Tests
Thyroid Neoplasms / blood,  complications,  diagnosis*
Thyroid Nodule / blood,  complications*
Tumor Markers, Biological / blood
Reg. No./Substance:
0/Tumor Markers, Biological; 5534-95-2/Pentagastrin; 9007-12-9/Calcitonin

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