Calcium-stimulated calcitonin test for the diagnosis of medullary thyroid cancer: results of a multicenter study and comparison between different assays.

Autor:	Faggiano A; Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ENETS Center of Excellence, Sapienza University, Rome, Italy - antongiulio.faggiano@uniroma1.it., Giannetta E; Department of Experimental Medicine, Sapienza University, Rome, Italy., Modica R; Unit of Endocrinology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy., Albertelli M; Unit of Endocrinology, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, Italy.; Unit of Endocrinology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Barba L; Unit of Endocrinology, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Naples, Italy., Dolce P; Departement of Public Health, University of Naples Federico II, Naples, Italy., Motta C; Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ENETS Center of Excellence, Sapienza University, Rome, Italy., Deiana MG; Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ENETS Center of Excellence, Sapienza University, Rome, Italy., Martinelli R; Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ENETS Center of Excellence, Sapienza University, Rome, Italy., Zamponi V; Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ENETS Center of Excellence, Sapienza University, Rome, Italy., Sesti F; Department of Experimental Medicine, Sapienza University, Rome, Italy., Patti L; Unit of Endocrinology, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, Italy., Scavuzzo F; Unit of Endocrinology, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Naples, Italy., Colao A; Unit of Endocrinology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.; UNESCO Chair "Education for Health and Sustainable Development", University of Naples Federico II, Naples, Italy., Monti S; Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ENETS Center of Excellence, Sapienza University, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Minerva endocrinology [Minerva Endocrinol (Torino)] 2023 Sep; Vol. 48 (3), pp. 253-260. Date of Electronic Publication: 2023 Jun 16.
DOI:	10.23736/S2724-6507.23.04017-4
Abstrakt:	Background: A basal serum calcitonin (Ct) increase >100 pg/mL in patients with a thyroid nodule is consistent with the diagnosis of medullary thyroid cancer (MTC). In cases where the CT test have a slight to moderate increase, the calcium gluconate stimulation test is helpful to increase diagnostic accuracy. However, reliable cut-offs for calcium-stimulated Ct are still lacking. The aim of this study was to evaluate the sex-specific calcium-stimulated Ct cutoffs for the diagnosis of MTC in a multicenter series. A comparison between different Ct assays has been also performed. Methods: 90 subjects undergone calcium-stimulated Ct for a suspected MTC in 5 Endocrine Units between 2010-2021 were retrospectively analyzed. Serum Ct concentrations were assessed by immunoradiometric (IRMA) or chemiluminescence (CLIA) assays. Results: MTC was diagnosed in 37 (41.1%) and excluded in 53 (58.9%) patients. The best calcium-stimulated Ct cut-off to identify MTC was 611 pg/mL in males (AUC =0.90, 95% CI (0.76;1) and 445 pg/mL in females (AUC=0.79, 95% CI (0.66;0.91). Logistic regression analysis showed that both basal (OR 1.01, P=0.003) and peak Ct after stimulation (OR 1.07, P=0.007) were significantly associated with MTC, together with sex (OR=0.06, P<0.001). The "Ct assay" variable was also considered in the logistic regression model, but it was not significantly associated with MTC (OR=0.93, P=0.919). Conclusions: This study indicates that calcium test could be helpful to identify patients with early-stage MTC and those without MTC. A Ct value of 611 pg/mL in males and 445 pg/mL in females are proposed as the optimal Ct cut-offs at the stimulation test.
Databáze:	MEDLINE
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