Routine calcitonin measurement in nodular thyroid disease management: is it worthwhile?
Annals of Surgical Treatment and Research
; : 173-178, 2017.
Article
em En
| WPRIM
| ID: wpr-170003
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE: To evaluate the diagnostic accuracy of routine calcitonin measurement in patients with nodular thyroid disease. METHODS: Consecutive patients with nodular thyroid disease (n = 640) were studied. Serum calcitonin levels were measured under basal conditions, and when basal values were between 10–100 pg/mL, testing was repeated after pentagastrin (PG) stimulation. Patients with previously diagnosed or familial medullary thyroid cancer (MTC) were excluded. Patients were operated on when basal or stimulated calcitonin >100 pg/mL or when other surgical indications were present. RESULTS: Four cases of MTC were identified. MTC was diagnosed in 75% of patients with basal calcitonin >100 pg/mL. One out of 11 patients with basal calcitonin between 10–100 pg/mL was diagnosed with MTC. PG stimulation resulted in elevation in 4 cases, where 1 case was diagnosed with MTC. Positive predictive value for basal calcitonin levels in the preoperative diagnosis of MTC was 5% for values between 10–100 pg/mL and 100% for values >100 pg/mL. Possible reasons for false positivity were papillary thyroid cancer in 17%, renal insufficiency in 8.3%, Hashimoto thyroiditis in 17% and β-blocker use in 33%. Positive predictive value for the PG test (>100 pg/mL) was 25% in the entire series. The cost of adding calcitonin measurement (±PG stimulation) to the preoperative work-up, resulted in €912.68 per MTC patient to detect the disease. CONCLUSION: Basal calcitonin measurement together with PG stimulation in cases of basal calcitonin >10 pg/mL detects MTC in 0.62% of patients with nodular thyroid disease.
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Base de dados:
WPRIM
Assunto principal:
Pentagastrina
/
Doenças da Glândula Tireoide
/
Glândula Tireoide
/
Calcitonina
/
Neoplasias da Glândula Tireoide
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Nódulo da Glândula Tireoide
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Diagnóstico
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Insuficiência Renal
/
Doença de Hashimoto
Tipo de estudo:
Diagnostic_studies
Aspecto:
Patient_preference
Limite:
Humans
Idioma:
En
Revista:
Annals of Surgical Treatment and Research
Ano de publicação:
2017
Tipo de documento:
Article