Skip to main content
SpringerLink
Log in

Calcitonin as Biomarker for the Medullary Thyroid Carcinoma

  • Chapter
  • First Online:
Book cover Medullary Thyroid Carcinoma

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 204))

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AUC:

Area under the curve

CTN :

Calcitonin

CGRP:

Calcitonin gene-related peptide

1,25–OH–Vitamin D3:

Calcitriol

Ca:

Calcium

CCH:

C-cell hyperplasia

CKD:

Chronic kidney disease

CV:

Coefficients of variation

FNAC:

Fine-needle aspiration cytology

H2RB:

Histamine-2 receptor blockers

IRMA:

Immunoradiometric assay

MTC :

Medullary thyroid carcinoma

mRNA:

Messenger ribonucleic acid

NID:

Nichols Institute Diagnostics

PCTN :

Procalcitonin

PG:

Pentagastrin

PPV:

Positive predictive value

PPI:

Proton pump inhibitor

RIA:

Radioimmunoassay

ROC:

Receiver operating curve

RfB:

Reference Institute for Bioanalytics

WHO:

World Health Organization

References

  • Ahmed SR, Ball DW (2011) Clinical review: incidentally discovered medullary thyroid cancer: diagnostic strategies and treatment. J Clin Endocrinol Metab 96:1237–1245

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Algeciras-Schimnich A, Preissner CM, Theobald JP, Finseth MS, Grebe SK (2009) Procalcitonin: a marker for the diagnosis and follow-up of patients with medullary thyroid carcinoma. J Clin Endocrinol Metab 94:861–868

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214

    Google Scholar 

  • Austin LA, Heath H 3rd (1981) Calcitonin: physiology and pathophysiology. N Engl J Med 304(5):269–278

    Article  CAS  PubMed  Google Scholar 

  • Barbot N, Guyetant S, Beldent V, Akrass A, Cerf I, Perdrisot R, Bigorgne JC (1991) Chronic autoimmune thyroiditis and C-cell hyperplasia. Study of calcitonin secretion in 24 patients. Ann Endocrinol (Paris) 52:109–112

    Google Scholar 

  • Basuyau JP, Mallet E, Leroy M, Brunelle P (2004) Reference intervals for serum calcitonin in men, women, and children. Clin Chem 50:1828–1830

    Article  CAS  PubMed  Google Scholar 

  • Becker KL, Müller B, Nylen ES et al (2002) Calcitonin gene family of peptides. Structure, molecular biology and effects. In: Bilezikian JP, Raisz LG, Rodan GA (eds) Principles of bone biology, 3rd edn. Academic Press, San Diego, pp 619–639

    Chapter  Google Scholar 

  • Becker KL, Nylén ES, White JC, Müller B, Snider RH Jr (2004) Clinical review 167: procalcitonin and the calcitonin gene family of peptides in inflammation, infection, and sepsis: a journey from calcitonin back to its precursors. J Clin Endocrinol Metab 89:1512–1525

    Article  CAS  PubMed  Google Scholar 

  • Bertagna XY, Bloomgarden ZT, Rabin D, Roberts LJ, Orth DN (1980) Molecular weight forms of immunoreactive calcitonin in a patient with medullary carcinoma of the thyroid: dynamic studies with calcium, pentagastrin and somatostatin. Clin Endocrinol (Oxf) 13(2):115–123

    Article  CAS  Google Scholar 

  • Bieglmayer C, Scheuba C, Niederle B, Flores J, Vierhapper H (2002) Screening for medullary thyroid carcinoma: experience with different immunoassays for human calcitonin. Wien Klin Wochenschr 114:267–273

    CAS  PubMed  Google Scholar 

  • Bieglmayer C, Vierhapper H, Dudczak R, Niederle B (2007) Measurement of calcitonin by immunoassay analyzers. Clin Chem Lab Med 45:662–666

    Article  CAS  PubMed  Google Scholar 

  • Bihan H, Becker KL, Snider RH, Nylen E, Vittaz L, Lauret C et al (2003) Calcitonin precursor levels in human medullary thyroid carcinoma. Thyroid 13:819–822

    Article  CAS  PubMed  Google Scholar 

  • Body JJ, Heath H 3rd (1984) “Nonspecific” increases in plasma immunoreactive calcitonin in healthy individuals: discrimination from medullary thyroid carcinoma by a new extraction technique. Clin Chem 30:511–514

    CAS  PubMed  Google Scholar 

  • Borchhardt KA, Hörl WH, Sunder-Plassmann G (2005) Reversibility of secondary hypercalcitoninemia’ after kidney transplantation. Am J Transplant 5:757–763

    Article  Google Scholar 

  • Boschin IM, Torresan F, Toniato A, Zane M, Ide EC, Pennelli G et al (2014) Incidental medullary thyroid microcarcinoma revealed by mild increase of preoperative serum calcitonin levels: therapeutic implications. Endocrine 45:448–453

    Article  CAS  PubMed  Google Scholar 

  • Bringhurst FR, Demay MB, Kronenberg HM (2011) Hormones and disorders of mineral metabolism. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM (eds) Williams textbook of endocrinology. Elsevier Saunders, Philadelphia, pp 1250–1252

    Google Scholar 

  • Bucht E, Tørring O, Sjöberg HE (1985) Gel chromatography of immunoextracted plasma calcitonin in response to the calcium clamp in healthy males. Acta Endocrinol (Copenh) 110:421–428

    CAS  Google Scholar 

  • Camacho CP, Lindsey SC, Kasamatsu TS, Machado AL, Martins JR, Biscolla RP et al (2014) Development and application of a novel sensitive immunometric assay for calcitonin in a large cohort of patients with medullary and differentiated thyroid cancer, thyroid nodules, and autoimmune thyroid diseases. Eur Thyroid J 3:117–124

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Care AD (1992) The regulation of the secretion of calcitonin. Bone Miner 16:182–185

    Article  CAS  PubMed  Google Scholar 

  • Chambers TJ, Moore A (1983) The sensitivity of isolated osteoclasts to morphological transformation by calcitonin. J Clin Endocrinol Metab 57:819–824

    Article  CAS  PubMed  Google Scholar 

  • Chambers TJ, McSheehy PM, Thomson BM, Fuller K (1985) The effect of calcium-regulating hormones and prostaglandins on bone resorption by osteoclasts disaggregated from neonatal rabbit bones. Endocrinology 116:234–239

    Article  CAS  PubMed  Google Scholar 

  • Chambon G, Alovisetti C, Idoux-Louche C, Reynaud C, Rodier M, Guedj AM et al (2011) The use of preoperative routine measurement of basal serum thyrocalcitonin in candidates for thyroidectomy due to nodular thyroid disorders: results from 2733 consecutive patients. J Clin Endocrinol Metab 96:75–81

    Article  CAS  PubMed  Google Scholar 

  • Chan T, Gu F (2011) Early diagnosis of sepsis using serum biomarkers. Expert Rev Mol Diagn 11:487–496

    Article  CAS  PubMed  Google Scholar 

  • Cohen R, Campos JM, Salaün C, Heshmati HM, Kraimps JL, Proye C et al (2000) Preoperative calcitonin levels are predictive of tumor size and postoperative calcitonin normalization in medullary thyroid carcinoma. Groupe d’Etudes des Tumeurs a Calcitonine (GETC). J Clin Endocrinol Metab 85:919–922

    Article  CAS  PubMed  Google Scholar 

  • Colombo C, Verga U, Mian C, Ferrero S, Perrino M, Vicentini L et al (2012) Comparison of calcium and pentagastrin tests for the diagnosis and follow-up of medullary thyroid cancer. J Clin Endocrinol Metab 97:905–913

    Article  CAS  PubMed  Google Scholar 

  • Copp DH, Cameron EC, Cheney BA, Davidson AG, Henze KG (1962) Evidence for calcitonin-a new hormone from the parathyroid that lowers blood calcium. Endocrinology 70:638–649

    Article  CAS  PubMed  Google Scholar 

  • Costante G, Meringolo D, Durante C, Bianchi D, Nocera M, Tumino S et al (2007) Predictive value of serum calcitonin levels for preoperative diagnosis of medullary thyroid carcinoma in a cohort of 5817 consecutive patients with thyroid nodules. J Clin Endocrinol Metab 92:450–455

    Article  CAS  PubMed  Google Scholar 

  • Costante G, Durante C, Francis Z, Schlumberger M, Filetti S (2009) Determination of calcitonin levels in C-cell disease: clinical interest and potential pitfalls. Nat Clin Pract Endocrinol Metab 5:35–44

    Article  CAS  PubMed  Google Scholar 

  • Cooper CW, Hirsch PF, Toverud SU, Munson PL (1967) An improved method for the biological assay of thyrocalcitonin. Endocrinology 81:610–616

    Article  CAS  PubMed  Google Scholar 

  • Daniels GH (2011) Screening for medullary thyroid carcinoma with serum calcitonin measurements in patients with thyroid nodules in the United States and Canada. Thyroid 21:1199–1207

    Article  CAS  PubMed  Google Scholar 

  • Davey RA, Findlay DM (2013) Calcitonin: physiology or fantasy? J Bone Miner Res 28:973–979

    Article  CAS  PubMed  Google Scholar 

  • Deftos LJ (1971) Immunoassay for human calcitonin. I. Method. Metabolism 20:1122–1128

    Article  CAS  PubMed  Google Scholar 

  • Deftos LJ, Lee MR, Potts JT Jr (1968) A radioimmunoassay for thyrocalcitonin. Proc Natl Acad Sci USA 60:293–299

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Deftos LJ, Roos BA, Bronzert D, Parthemore JG (1975) Immunochemical heterogeneity of calcitonin in plasma. J Clin Endocrinol Metab 40:409–412

    Article  CAS  PubMed  Google Scholar 

  • d’Herbomez M, Leclerc L, Vantyghem MC, Fourrier F, Proye C, Wemeau JL (2001) Clinical evaluation of a new sensitive calcitonin assay: study of specificity. Clin Chim Acta 311:149–155

    Article  PubMed  Google Scholar 

  • d’Herbomez M, Caron P, Bauters C, Do Cao C, Schlienger JL, Sapin R, Baldet L, Carnaille B, Wémeau JL, French Group GTE (Groupe des Tumeurs Endocrines) (2007) Reference range of serum calcitonin levels in humans: influence of calcitonin assays, sex, age, and cigarette smoking. Eur J Endocrinol 157:749–755

    Google Scholar 

  • Elisei R, Bottici V, Luchetti F, Di Coscio G, Romei C, Grasso L et al (2004) Impact of routine measurement of serum calcitonin on the diagnosis and outcome of medullary thyroid cancer: experience in 10,864 patients with nodular thyroid disorders. J Clin Endocrinol Metab 89:163–168

    Article  CAS  PubMed  Google Scholar 

  • Engelbach M, Heerdt S, Görges R, Kunt T, Pfützner A, Forst T et al (1998) Is there an ectopic secretion of monomeric calcitonin in the human being? Langenbecks Arch Surg 83:456–459

    Article  Google Scholar 

  • Engelbach M, Görges R, Forst T, Pfützner A, Dawood R, Heerdt S et al (2000) Improved diagnostic methods in the follow-up of medullary thyroid carcinoma by highly specific calcitonin measurements. J Clin Endocrinol Metab 85:1890–1894

    CAS  PubMed  Google Scholar 

  • Erdogan MF, Güllü S, Başkal N, Uysal AR, Kamel N, Erdoğan G (1997) Omeprazole calcitonin stimulation test for the diagnosis follow-up and family screening in medullary thyroid carcinoma. J Clin Endocrinol Metab 82:897–899

    Article  CAS  PubMed  Google Scholar 

  • Erdogan MF, Gursoy A, Kulaksizoglu M (2006) Long-term effects of elevated gastrin levels on calcitonin secretion. J Endocrinol Invest 29:771–775

    Article  CAS  PubMed  Google Scholar 

  • Escalada J, Teruel JL, Pavón I, Vila T, Navarro J, Varela C (1993) Normal calcitonin response to pentagastrin stimulation in patients with chronic renal failure. Acta Endocrinol (Copenh) 129:39–41

    Google Scholar 

  • Friedmann PA, Gesek FA (1995) Cellular calcium transport in renal epithelia: measurement, mechanisms and regulation. Physiol Rev 75:429–471

    Google Scholar 

  • Freston JW (1994) Omeprazole, hypergastrinemia, and gastric carcinoid tumors. Ann Intern Med 121:232–233

    Article  CAS  PubMed  Google Scholar 

  • Fugazzola L (2013) Stimulated calcitonin cut-offs by different tests. Eur Thyroid J 2:49–56

    PubMed Central  CAS  PubMed  Google Scholar 

  • Garancini S, Ballada L, Roncari G, Gastaldi L (1983) Calcitonin in chronic renal failure. Nephron 34:224–227

    Article  CAS  PubMed  Google Scholar 

  • Garrett JE, Tamir H, Kifor O, Simin RT, Rogers KV, Mithal A et al (1995) Calcitonin-secreting cells of the thyroid express an extracellular calcitonin receptor gene. Endocrinology 136:5202–5211

    CAS  PubMed  Google Scholar 

  • Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L et al; AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules (2010) Endocr Pract 16 Suppl 1:1–43

    Google Scholar 

  • Gibelin H, Essique D, Jones C, Levillain P, Maréchaud R, Kraimps JL (2005) Increased calcitonin level in thyroid nodules without medullary carcinoma. Br J Surg 92:574–578

    Article  CAS  PubMed  Google Scholar 

  • Giovanella L (2012) Serum procalcitonin and calcitonin normal values before and after calcium gluconate infusion. Exp Clin Endocrinol Diabetes 120:169–170

    Article  CAS  PubMed  Google Scholar 

  • Goltzman D, Tischler AS (1978) Characterization of the immunochemical forms of calcitonin released by a medullary thyroid carcinoma in tissue culture. J Clin Invest 61:449–458

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Grauer A, Raue F, Ziegler R (1998) Clinical usefulness of a new chemiluminescent two-site immunoassay for human calcitonin. Exp Clin Endocrinol Diabetes 106:353–359

    Article  CAS  PubMed  Google Scholar 

  • Guesgen C, Willms A, Zwad A, Waldeck S, Wieler H, Schwab R (2013) Investigation of factors potentially influencing calcitonin levels in the screening and follow-up for medullary thyroid carcinoma: a cautionary note. BMC Clin Pathol 13:27

    Google Scholar 

  • Hahm JR, Lee MS, Min YK, Lee MK, Kim KW, Nam SJ et al (2001) Routine measurement of serum calcitonin is useful for early detection of medullary thyroid carcinoma in patients with nodular thyroid diseases. Thyroid 11:73–80

    Article  CAS  PubMed  Google Scholar 

  • Heath H 3rd, Sizemore GW (1977) Plasma calcitonin in normal man. Differences between men and women. J Clin Invest 60:1135–1140

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Heath H 3rd, Sizemore GW (1979) Immunochemical heterogeneity of calcitonin in tumor, tumor venous effluent, and peripheral blood of patients with medullary thyroid carcinoma. J Lab Clin Med 93:390–401

    PubMed  Google Scholar 

  • Hirsch PF, Lester GE, Talmage RV (2001) Calcitonin, an enigmatic hormone does it have a function? J Musculoskelet Neuronal Interact 1:299–305

    CAS  PubMed  Google Scholar 

  • Hirsch PF, Voelkel EF, Munson PL (1964) Thyrocalcitonin: Hypocalcemic hypophospatemic principle of the thyroid gland. Science 146:412–413

    Google Scholar 

  • Hurley DL, Tiegs RD, Wahner HW, Heath H 3rd (1987) Axial and appendicular bone mineral density in patients with long-term deficiency or excess of calcitonin. N Engl J Med 317:537–541

    Article  CAS  PubMed  Google Scholar 

  • Kaczka K, Mikosiński S, Fendler W, Celnik A, Pomorski L (2012) Calcitonin and procalcitonin in patients with medullary thyroid cancer or bacterial infection. Adv Clin Exp Med 21:169–178

    PubMed  Google Scholar 

  • Kanis JA, Adams ND, Cecchettin M, Luizetto G, Gaspar S, Heynen G (1979) Ethanol induced secretion of calcitonin in chronic renal disease. Clin Endocrinol (Oxf) 10:155–161

    Article  CAS  Google Scholar 

  • Kapoor D, Jones TH (2005) Smoking and hormones in health and endocrine disorders. Eur J Endocrinol 152:491–499

    Article  CAS  PubMed  Google Scholar 

  • Karges W, Dralle H, Raue F, Mann K, Reiners C, Grussendorf M et al; German Society for Endocrinology (DGE)—Thyroid Section (2004) Calcitonin measurement to detect medullary thyroid carcinoma in nodular goiter: German evidence-based consensus recommendation. Exp Clin Endocrinol Diabetes 112:52–58

    Google Scholar 

  • Kim HK, Bae WK, Choi YD, Shim HJ, Yoon JH, Kang HC (2014) Serum calcitonin may falsely estimate tumor burden in chronic hypercalcemia: a case of prostatic and multiple bone metastases from medullary thyroid cancer. Thyroid 24:599–603

    Article  CAS  PubMed  Google Scholar 

  • Klinkenberg-Knol EC, Festen HP, Jansen JB, Lamers CB, Nelis F, Snel P et al (1994) Long-term treatment with omeprazole for refractory reflux esophagitis: efficacy and safety. Ann Intern Med 121:161–167

    Article  CAS  PubMed  Google Scholar 

  • Kotzmann H, Schmidt A, Scheuba C, Kaserer K, Watschinger B, Söregi G et al (1999) Basal calcitonin levels and the response to pentagastrin stimulation in patients after kidney transplantation or on chronic hemodialysis as indicators of medullary carcinoma. Thyroid 9:943–947

    Article  CAS  PubMed  Google Scholar 

  • Kratzsch J, Petzold A, Raue F, Reinhardt W, Bröcker-Preuss M, Görges R et al (2011) Basal and stimulated calcitonin and procalcitonin by various assays in patients with and without medullary thyroid cancer. Clin Chem 57:467–474

    Article  CAS  PubMed  Google Scholar 

  • Leboeuf R, Langlois M, Martin M, Ahnadi CE, Fink GD (2006) “Hook effect” in calcitonin immunoradiometric assay in patients with metastatic medullary thyroid carcinoma: case report and review of the literature. J Clin Endocrinol Metab 91:361–364

    Article  CAS  PubMed  Google Scholar 

  • Lee JC, Parthemore JG, Deftos LJ (1977) Immunochemical heterogeneity of calcitonin in renal failure. J Clin Endocrinol Metab 45:528–533

    Article  CAS  PubMed  Google Scholar 

  • Machens A, Hauptmann S, Dralle H (2008) Medullary thyroid cancer responsiveness to pentagastrin stimulation: an early surrogate parameter of tumor dissemination? J Clin Endocrinol Metab 93:2234–2238

    Article  CAS  PubMed  Google Scholar 

  • Machens A, Lorenz K, Dralle H (2014) Utility of serum procalcitonin for screening and risk stratification of medullary thyroid cancer. J Clin Endocrinol Metab 99:2986–2994

    Article  CAS  PubMed  Google Scholar 

  • Martínez ME, Miguel JL, Gómez P, Selgas R, Salinas M, Gentil M et al (1983) Plasma calcitonin concentration in patients treated with chronic dialysis: differences between hemodialysis and CAPD. Clin Nephrol 19:250–253

    PubMed  Google Scholar 

  • MacIntyre I, Girgis SI, Hillyard CJ (1984) Essential steps in the measurement of normal circulating levels of calcitonin. Biomed Pharmacother 38:230–234

    CAS  PubMed  Google Scholar 

  • Marx SJ, Woodward CJ, Aurbach GD (1972) Calcitonin receptors of kidney and bone. Science 178:999–1001

    Article  CAS  PubMed  Google Scholar 

  • Mian C, Perrino M, Colombo C, Cavedon E, Pennelli G, Ferrero S et al (2014) Refining calcium test for the diagnosis of medullary thyroid cancer: cutoffs, procedures, and safety. J Clin Endocrinol Metab 99:1656–1664

    Article  CAS  PubMed  Google Scholar 

  • Milone F, Ramundo V, Chiofalo MG, Severino R, Paciolla I, Pezzullo L et al (2010) Predictive value of pentagastrin test for preoperative differential diagnosis between C-cell hyperplasia and medullary thyroid carcinoma in patients with moderately elevated basal calcitonin levels. Clin Endocrinol (Oxf) 73:85–88

    CAS  Google Scholar 

  • Morimoto S, Okada Y, Onishi T, Takai S, Miyauchi A, Lee S et al (1981) Heterogeneity of plasma and urinary immunoreactive calcitonin in patients with medullary carcinoma of the thyroid. Endocrinol Jpn 28:583–594

    Article  CAS  PubMed  Google Scholar 

  • Motté P, Vauzelle P, Gardet P, Ghillani P, Caillou B, Parmentier C et al (1988) Construction and clinical validation of a sensitive and specific assay for serum mature calcitonin using monoclonal anti-peptide antibodies. Clin Chim Acta 174:35–54

    Article  PubMed  Google Scholar 

  • Mulder H, Silberbusch J, Hackeng WH, Koorevaar G, den Ottolander GJ (1982) Enhanced calcitonin release in chronic renal failure depending on the absence of severe secondary hyperparathyroidism. Nephron. 31:123–128

    Article  CAS  PubMed  Google Scholar 

  • Mulder H, Hackeng WH, vd Lely AJ, Siersema-Smallegange M (1990) Change of serum calcitonin in patients receiving glucocorticoids: an acute phase study. Neth J Med 36:288–290

    Google Scholar 

  • Niccoli P, Brunet P, Roubicek C, Roux F, Baudin E, Lejeune PJ et al (1995) Abnormal calcitonin basal levels and pentagastrin response in patients with chronic renal failure on maintenance hemodialysis. Eur J Endocrinol 132:75–81

    Article  CAS  PubMed  Google Scholar 

  • Pacini F, Fontanelli M, Fugazzola L, Elisei R, Romei C, Di Coscio G et al (1994) Routine measurement of serum calcitonin in nodular thyroid diseases allows the preoperative diagnosis of unsuspected sporadic medullary thyroid carcinoma. J Clin Endocrinol Metab 78:826–829

    CAS  PubMed  Google Scholar 

  • Pacini F, Schlumberger M, Dralle H, Elisei R, Smit JW, Wiersinga W; European Thyroid Cancer Taskforce (2006) European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol 154:787–803 (Erratum in: Eur J Endocrinol 155:385)

    Google Scholar 

  • Papapetrou PD, Polymeris A, Karga H, Vaiopoulos G (2006) Heterophilic antibodies causing falsely high serum calcitonin values. J Endocrinol Invest 29:919–923

    Article  CAS  PubMed  Google Scholar 

  • Polymeris A, Papapetrou PD, Papandroulaki F, Thanou S (2011) Hyperinsulinemia during oral glucose tolerance test and high normal serum cortisol are associated with increased secretion of calcitonin in normal subjects. Hormones (Athens) 10:304–312

    Article  Google Scholar 

  • Parthemore JG, Bronzert D, Roberts G, Deftos LJ (1974) A short calcium infusion in the diagnosis of medullary thyroid carcinoma. J Clin Endocrinol Metab 39:108–111

    Article  CAS  PubMed  Google Scholar 

  • Pina G, Dubois S, Murat A, Berger N, Niccoli P, Peix JL et al.; Groupe de Tumeurs Endocrines (2013) Is basal ultrasensitive measurement of calcitonin capable of substituting for the pentagastrin-stimulation test? Clin Endocrinol (Oxf) 78:358–364. RfB4/2014:http://www.dgkl.rfb.de/cgi/displayAnaStats?rv_type=TM&rvTypeForDetails=TM&year=2014&rv_num=4&analyte=all&searchType=rv_type&anaV=19). Assessed on 24 Mar 2014

  • Rink T, Truong PN, Schroth HJ, Diener J, Zimny M, Grünwald F (2009) Calculation and validation of a plasma calcitonin limit for early detection of medullary thyroid carcinoma in nodular thyroid disease. Thyroid 19:327–332

    Article  CAS  PubMed  Google Scholar 

  • Roche cobas, calcitonin product characteristic. http://www.cobas.com/home/product/clinical-and-immunochemistry-testing/elecsys-calcitonin.html. Assessed on 24 Mar 2015

  • Saller B, Görges R, Reinhardt W, Haupt K, Janssen OE, Mann K (2002) Sensitive calcitonin measurement by two-site immunometric assays: implications for calcitonin screening in nodular thyroid disease. Clin Lab 48:191–200

    CAS  PubMed  Google Scholar 

  • Scheuba C, Kaserer K, Weinhäusl A, Pandev R, Kaider A, Passler C et al (1999) Is medullary thyroid cancer predictable? A prospective study of 86 patients with abnormal pentagastrin tests. Surgery 126:1089–1095

    Article  CAS  PubMed  Google Scholar 

  • Schifter S (1993) A new highly sensitive radioimmunoassay for human calcitonin useful for physiological studies. Clin Chim Acta 215:99–109

    Article  CAS  PubMed  Google Scholar 

  • Singer FR, Habener JF (1974) Multiple immunoreactive forms of calcitonin in human plasma. Biochem Biophys Res Commun 61:710–716

    Article  CAS  PubMed  Google Scholar 

  • Sizemore GW, Hpeath H 3rd, Larson JM (1975) Immunochemical heterogeneity of calcitonin in plasma of patients with medullary thryoid carcinoma. J Clin Invest 55:1111–1118

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Snider RH, Silva OL, Moor CF, Becker KL (1977) Clin Chim Acta. Immunochemical heterogeneity of calcitonin in man: effect on radioimmunoassay 76:1–14

    Google Scholar 

  • Steinbach G, Rau B, Debard AL, Javourez JF, Bienvenu J, Ponzio A et al (2004) Multicenter evaluation of a new immunoassay for procalcitonin measurement on the Kryptor System. Clin Chem Lab Med 42:440–449

    Article  CAS  PubMed  Google Scholar 

  • Tate J, Ward G (2004) Interferences in immunoassay. Clin Biochem Rev 25:105–120

    PubMed Central  PubMed  Google Scholar 

  • Thiem U, Marculescu R, Cejka D, Gessl A, Borchhardt K (2014) Low-dose calcium versus pentagastrin for stimulation of calcitonin in chronic hemodialysis patients: a pilot study. J Clin Endocrinol Metab 99:4704–4711

    Article  CAS  PubMed  Google Scholar 

  • Tobler PH, Tschopp FA, Dambacher MA, Born W, Fischer JA (1983) Identification and characterization of calcitonin forms in plasma and urine of normal subjects and medullary carcinoma patients. J Clin Endocrinol Metab 57:749–754

    Article  CAS  PubMed  Google Scholar 

  • Toledo SP, Lourenço DM Jr, Santos MA, Tavares MR, Toledo RA, Correia-Deur JE (2009) Hypercalcitoninemia is not pathognomonic of medullary thyroid carcinoma. Clinics (Sao Paulo) 64:699–706

    Article  Google Scholar 

  • Tommasi M, Raspanti S (2007a) Hook effect in calcitonin immunoradiometric assay. Clin Chem Lab Med 45:1073–1074

    Article  CAS  PubMed  Google Scholar 

  • Tommasi M, Raspanti S (2007b) Comparison of calcitonin determinations by polyclonal and monoclonal IRMAs. Clin Chem 53:798–799

    Article  CAS  PubMed  Google Scholar 

  • Uhrova J, Brodska H, Vanickova Z, Benakova H, Zima T (2011) Procalcitonin interference in an immunometric calcitonin assay. Scand J Clin Lab Invest 71:157–162

    CAS  PubMed  Google Scholar 

  • Uwaifo GI, Remaley AT, Stene M, Reynolds JC, Yen PM, Snider RH et al (2001) A case of spurious hypercalcitoninemia: a cautionary tale on the use of plasma calcitonin assays in the screening of patients with thyroid nodules for neoplasia. J Endocrinol Invest 24:361–369

    Article  CAS  PubMed  Google Scholar 

  • Vantyghem MC, Danel T, Marcelli-Tourvieille S, Moriau J, Leclerc L, Cardot-Bauters C et al (2007) Calcitonin levels do not decrease with weaning in chronic alcoholism. Thyroid 17:213–217

    Article  CAS  PubMed  Google Scholar 

  • Vieira AE, Mello MP, Elias LL, Lau IF, Maciel LM, Moreira AC, Castro M (2002) Molecular and biochemical screening for the diagnosis and management of medullary thyroid carcinoma in multiple endocrine neoplasia type 2A. Horm Metab Res 34:202–206

    Article  CAS  PubMed  Google Scholar 

  • Vitale G, Ciccarelli A, Caraglia M, Galderisi M, Rossi R, Del Prete S et al (2002) Comparison of two provocative tests for calcitonin in medullary thyroid carcinoma: omeprazole vs pentagastrin. Clin Chem 48:1505–1510

    CAS  PubMed  Google Scholar 

  • Voelkel EF, Tashjian AH Jr (1971) Measurement of thyrocalcitonin-like activity in urine of patients with medullary carcinoma. J Clin Endocrinol Metab 32:102–109

    Article  CAS  PubMed  Google Scholar 

  • Walter MA, Meier C, Radimerski T, Iten F, Kränzlin M, Müller-Brand J et al (2010) Procalcitonin levels predict clinical course and progression-free survival in patients with medullary thyroid cancer. Cancer 116:31–40

    CAS  PubMed  Google Scholar 

  • Zaidi M, Moonga BS, Abe E (2002) Calcitonin and bone formation: a knockout full of suprises. J Clin Invest 110:1769–1771

    Google Scholar 

  • Zayed AA, Alzubaidi M, Atallah S, Momani MS, Al-Delaimy WK (2013) Should food intake and circadian rhythm be considered when measuring serum calcitonin level? Endocr Pract 19:620–626

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institut für Laboratoriumsmedizin, Klinische Chemie und Molekulare Diagnostik, Universität Leipzig, Paul-List-Str. 13-15, 04103, Leipzig, Germany

    Yoon Ju Bae, Michael Schaab & Juergen Kratzsch

Authors
  1. Yoon Ju Bae
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Schaab
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Juergen Kratzsch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Juergen Kratzsch .

Editor information

Editors and Affiliations

  1. Endocrine Practice and Molecular Laboratory, Medical Faculty, University of Heidelberg , Heidelberg, Germany

    Friedhelm Raue

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Bae, Y.J., Schaab, M., Kratzsch, J. (2015). Calcitonin as Biomarker for the Medullary Thyroid Carcinoma. In: Raue, F. (eds) Medullary Thyroid Carcinoma. Recent Results in Cancer Research, vol 204. Springer, Cham. https://doi.org/10.1007/978-3-319-22542-5_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-22542-5_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22541-8

  • Online ISBN: 978-3-319-22542-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation