calca-protein--human and Thyroid-Nodule

The aim of the present study was to perform a systematic review of published studies to provide a robust estimation of the use of procalcitonin (ProCT) as a diagnostic marker of medullary thyroid carcinoma (MTC), with particular focus on its specificity and negative predictive value in excluding MTC. A comprehensive computer literature search was conducted to find relevant published articles on the topic. We used a search algorithm based on a combination of the terms 'medullary,' 'thyroid,' and 'ProCT.' The search was updated until February 2015. To expand our search, references of the retrieved articles were also screened. A total of 39 articles were retrieved, of which nine original papers published from 2003 to 2014 were selected for the review. Some of these studies used ProCT in the preoperative diagnosis of MTC, whereas others measured ProCT during the follow-up of patients who had been previously treated for MTC. Other laboratory measurements were performed in some of the included studies. The results of the majority of the studies indicate that ProCT measurement appears to be a very promising and reliable serum marker for the diagnosis of MTC, and it is not inferior to calcitonin (CT). The sample handling is less laborious, and in the few CT-negative cases reviewed, the assay had even greater sensitivity. It would be worthwhile to establish cutoff levels using larger patient series, because we speculate that this assay could potentially replace CT measurement in the future.

Topics: Biomarkers, Tumor; Calcitonin; Calcitonin Gene-Related Peptide; Carcinoma, Neuroendocrine; Humans; Protein Precursors; Thyroid Neoplasms; Thyroid Nodule

To prospectively evaluate the role of procalcitonin (PCT) in detecting or excluding medullary thyroid carcinoma (MTC) among patients with thyroid nodules and increased calcitonin (CT) levels.. Fourteen of 1236 patients referred for thyroid nodules had increased serum CT >10 pg/mL. A stimulation test with pentagastrin was done and both CT and PCT were measured after stimulation. All patients underwent thyroid ultrasound, fine-needle cytology and, if indicated, surgery with histological and immunohistochemical examination of the surgical specimens.. After follow-up, two MTCs were found. These two patients had basal CT >100 pg/mL and detectable (>0.1 ng/mL) PCT, with 100% sensitivity. Pentagastrin stimulated CT achieved values above 100 pg/mL in two MTCs and in other two cases with no MTC outcome (50% PPV and 83% NPV). On the contrary, all patients with no MTC had both basal and stimulated undetectable PCT (100% PPV and 100% NPV).. The addition of basal PCT measurement in patients with thyroid nodule(s) and increased CT may significantly improve accuracy of CT measurement without needing a PG stimulation test.

Topics: Adult; Aged; Biomarkers, Tumor; Biopsy, Fine-Needle; Calcitonin; Calcitonin Gene-Related Peptide; Carcinoma, Neuroendocrine; Female; Humans; Male; Middle Aged; Pentagastrin; Predictive Value of Tests; Protein Precursors; Thyroid Gland; Thyroid Neoplasms; Thyroid Nodule; Ultrasonography

Topics: Adult; Calcitonin; Calcitonin Gene-Related Peptide; Carcinoma; Case-Control Studies; Female; Humans; Male; Middle Aged; Prognosis; Protein Precursors; Sensitivity and Specificity; Thyroid Neoplasms; Thyroid Nodule; Thyroidectomy; Up-Regulation; Young Adult