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Horm Metab Res 2018; 50(01): 23-28
DOI: 10.1055/s-0043-122237
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Measurement of Basal Serum Calcitonin for the Diagnosis of Medullary Thyroid Cancer

Stephanie Allelein   *
1   Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
,
Margret Ehlers   *
1   Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
,
Corinna Morneau
1   Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
,
Katharina Schwartz
2   Department of Surgery, Lukas Hospital, Neuss, Germany
,
Peter E. Goretzki
2   Department of Surgery, Lukas Hospital, Neuss, Germany
,
Thomas Seppel
3   Outpatient Clinic for Endocrinology, Moenchengladbach, Germany
,
Joachim Feldkamp
4   Department for Endocrinology and Diabetes, Municipal Hospital Bielefeld, Bielefeld, Germany
,
Andreas Krieg
5   Department of General, Visceral and Pediatric Surgery, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
,
Wolfram Trudo Knoefel
5   Department of General, Visceral and Pediatric Surgery, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
,
Anne Kuebart
1   Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
,
Matthias Haase
1   Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
,
Till Dringenberg
1   Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
,
Christine Schmid
1   Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
,
Matthias Schott
1   Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
› Author Affiliations
Further Information

Publication History

received 14 August 2017

accepted 24 October 2017

Publication Date:
23 November 2017 (online)

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Abstract

Calcitonin (CT), a tumor marker for medullary thyroid cancer (MTC), can be stimulated with pentagastrin or calcium. Because of the unavailability of pentagastrin, basal CT measurement is frequently used for the preoperative diagnosis of MTC. The aim of the study was to define basal serum calcitonin (bCT) cut-off thresholds for diagnosing MTC. Within a retrospective analysis, 114 patients (51 males) were included fulfilling the criteria of an increased preoperative bCT level (>10 pg/ml) and the criteria of an available postoperative histology analysis. Based on a ROC plot analysis, the cut-off values for the diagnosis of MTC vs. non-malignancy (C cell hyperplasia and goiter) were identified. The most precise bCT thresholds for the identification of MTC were ≥46 pg/ml for males (sensitivity: 93.6%, specificity: 95.0%, PPV: 97%, NPV: 90%) and ≥35 pg/ml for females (sensitivity: 87.3%, specificity: 87.5%, PPV: 98%, NPV: 50%). Using these cut-offs, only 6% of male patients were not identified of having MTC, whereas 5% were false positive (having instead C cell hyperplasia). In females, the discrepancy was higher since 13% of female MTC patients were false negative by using the cut-off of ≥35 pg/ml, and 13% had false positive results (suffering from C cell hyperplasia). Gender-specific bCT cut-offs for the identification of MTC vs. C cell hyperplasia and non-malignancy were defined, which can be used in clinical routine. In female patients, however, the accuracy is much lower compared to males.

Key words

c cell hyperplasia - threshold - diagnosis

* Both authors contributed equally to this work


 

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