Document Detail


Comparison of Calcium and Pentagastrin Tests for the Diagnosis and Follow-Up of Medullary Thyroid Cancer.
MedLine Citation:
PMID:  22170709     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Context: The evaluation of basal calcitonin (bCT) and stimulated calcitonin (sCT) can be used for the diagnosis and follow-up of medullary thyroid cancer (MTC).Objective:The aim of this study was to evaluate the reliability of high-calcium (Ca) test and to identify gender-specific thresholds for MTC diagnosis.Patients:Patients with MTC in remission (n = 24) or in persistence (n = 18), RET gene mutations carriers (n = 14), patients with nodular goiter (n = 69), and healthy volunteers (n = 16) were submitted to pentagastrin and Ca (25 mg/kg) tests.Results:In all groups, the levels of calcitonin (CT) stimulated by either pentagastrin or Ca were significantly correlated. The prevalence of both C-cell hyperplasia (CCH) and MTC in women and men paralleled the increasing basal and peak CT levels in a gender-specific manner. Receiver operating characteristic plot analyses showed that the best levels of bCT to separate normal and CCH cases from MTC patients were above 18.7 pg/ml in females and above 68 pg/ml in males. Furthermore, Ca sCT above 184 pg/ml in females and above 1620 pg/ml in males had the highest accuracy to distinguish normal and CCH cases from patients with MTC. At the C-cell immunohistochemical examination, Ca sCT below 50 pg/ml corresponded to a mean number of 30 cells per 10 fields, whereas higher sCT associated with a mean number of 400 cells per 10 fields, often displaying a diffuse and nodular distribution pattern.Conclusions:High-dose Ca test is a potent and well-tolerated procedure that can be applied worldwide at a low cost. Reference ranges for Ca sCT levels in different groups of patients and CT thresholds to diagnose CCH/MTC have been identified.
Authors:
Carla Colombo; Uberta Verga; Caterina Mian; Stefano Ferrero; Michela Perrino; Leonardo Vicentini; Davide Dazzi; Giuseppe Opocher; Maria Rosa Pelizzo; Paolo Beck-Peccoz; Laura Fugazzola
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-14
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  -     ISSN:  1945-7197     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Medical Sciences (C.C., M.P., P.B.-P., L.F.) and Medicine, Surgery and Dentistry (S.F.), University of Milan, 20122 Milan, Italy; Endocrinology and Diabetology Unit (U.V., P.B.-P., L.F.), Pathology Unit (S.F.), and Endocrine Surgery Unit (L.V.), Fondazione Ca'Granda-Instituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20122 Milan, Italy; Endocrine Unit (C.M.) and Special Surgery Unit (M.R.P.), Department of Medical and Surgical Sciences, University of Padova, 35122 Padova, Italy; Division of Internal Medicine (D.D.), Ospedale di Fidenza, 43036 Fidenza, Italy; and Veneto Institute of Oncology IRCCS (G.O.), 35128 Padova, Italy.
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