Basal and Stimulated Calcitonin and Procalcitonin by Various Assays in Patients with and without Medullary Thyroid Cancer
| Autor: | Martina Bröcker-Preuβ, Klaus Mann, Anne Petzold, W. Reinhardt, Christoph Reiners, Friedhelm Raue, Rainer Görges, Wolfram Karges, Henning Dralle, Joachim Thiery, Dagmar Führer, Markus Luster, Nils G. Morgenthaler, Jürgen Kratzsch |
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| Rok vydání: | 2011 |
| Předmět: |
Calcitonin
Male medicine.medical_specialty Calcitonin Gene-Related Peptide Clinical Biochemistry Medizin Sensitivity and Specificity Gastroenterology Procalcitonin Cohort Studies Automation Basal (phylogenetics) Internal medicine Biomarkers Tumor medicine Humans Thyroid Neoplasms Protein Precursors Thyroid cancer Immunoassay Sex Characteristics Protein Stability business.industry Biochemistry (medical) Cancer Medullary thyroid cancer Reference Standards medicine.disease Pentagastrin Endocrinology Carcinoma Medullary Case-Control Studies Calibration Luminescent Measurements Thyroidectomy Female business Kidney disease medicine.drug |
| Zdroj: | Clinical Chemistry. 57:467-474 |
| ISSN: | 1530-8561 0009-9147 |
| DOI: | 10.1373/clinchem.2010.151688 |
| Popis: | BACKGROUND Calcitonin (CT) is a sensitive marker for evaluation of medullary thyroid cancer (MTC). However, CT measurement can vary with assay- and nonassay-dependent factors, and procalcitonin (PCT) measurement has been proposed for evaluating questionable increases in CT. METHODS We tested 2 fully automated CT assays (Immulite [IL] and Liaison [LIA]) and 1 nonautomated CT assay (IRMA, Medipan) and compared these results with PCT (Brahms Kryptor). We evaluated preanalytical conditions and PCT cross-reactivity in sera of 437 patients with clinical conditions associated with hypercalcitoninemia. Additionally, we determined the true “nil” CT concentration in 60 thyroidectomized patients and defined CT cutoff concentrations for pentagastrin stimulation testing in 13 chronic kidney disease (CKD) patients and 10 MTC patients. RESULTS Markedly decreased CT concentrations were found after storage of sera for >2 h at room temperature and >6 h at 4 °C. Cutoff concentrations for basal and stimulated CT were disease and assay dependent. Proton pump inhibitor therapy was the most frequent reason for increased CT. PCT concentrations were higher in patients with MTC than in patients with CKD without infections (P < 0.001). Whereas IL and LIA demonstrated comparable analytical quality, the IRMA gave increased CT concentrations in nil sera and showed cross-reactivity with PCT in patients with concomitant bacterial infection. CONCLUSIONS IL, LIA, and IRMA detected increased CT concentrations in non-MTC patients and discriminated MTC from CKD patients in pentagastrin tests. PCT assessment may be helpful in the diagnostic work-up of increased CT concentrations in questionable clinical circumstances. |
| Databáze: | OpenAIRE |
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