The results of a new meta-analysis show that procalcitonin (ProCT) is an accurate biomarker for the diagnosis and monitoring of medullary thyroid carcinoma (MTC). The research was published in The Journal of Clinical Endocrinology & Metabolism.

The pooled sensitivity and specificity for serum ProCT as a diagnostic tool were 0.90 (95% CI, 0.71-0.97) and 1.00 (95% CI, 0.85-1.00), respectively.

Based on the results, the authors stated, “The high accuracy, compounded with favorable analytical characteristics, give ProCT great potential to replace calcitonin as a new standard of care in the management of MTC.”

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Additional tests of ProCT’s predictive value supported its use as a diagnostic tool. The pooled positive and negative likelihood ratios were 288 (95% CI, 5.6-14929.3) and 0.10 (95% CI, 0.03-0.33), respectively, indicating large shifts in the probability of accurate diagnosis. The area under the curve (0.97; 95% CI, 0.95-0.98) and the positive and negative predictive values (99% and 2%, respectively) were also strongly supportive of ProCT’s diagnostic potential.

The meta-analysis included data from 11 studies (4.5% of the identified studies) that compared ProCT and calcitonin and also met the inclusion criteria. The study data quality and validity were assessed using the QUADAS-2 tool. The pooled data yielded a total of 5817 patients, with 335 having confirmed MTC. Hierarchical summary receiver operator characteristic (HSROC) and bivariate methods were applied to assess the pooled predictive quality of ProCT.

MTC is a rare form of thyroid cancer that arises from parafollicular or C cells, which are mainly concentrated in the upper poles of the thyroid lobes. The malignant C cells secrete elevated levels of calcitonin and carcinoembryonic antigen. The elevated levels of these 2 biomarkers are traditionally used in the diagnosis of MTC. 


Giovanella L, Garo ML, Ceriani L, Paone G, Campenni A, D’Aurizio F. Procalcitonin as an alternative tumor marker of medullary thyroid carcinoma. A meta-analysis. J Clin Endocrinol Metab. Published online August 12, 2021. doi:10.1210/clinem/dgab564

Medullary thyroid carcinoma (MTC): overview. Rare Disease Advisor. Accessed August 13, 2021.

Medullary thyroid carcinoma (MTC): diagnosis. Rare Disease Advisor. Accessed August 13, 2021.