Researchers discovered that procalcitonin measurements were not superior to basal calcitonin for the diagnosis of sporadic medullary thyroid carcinoma (MTC) in patients with the nodular disease and mild to moderate hypercalcitoninemia, as published in Endocrine Care.
Many studies recommend measuring serum calcitonin for the screening of sporadic MTC in patients who have thyroid nodules. Rosario and Mourão reasoned that procalcitonin measurements can complement calcitonin as procalcitonin levels are almost always higher in MTC. Hence, they decided to investigate the utility of procalcitonin in diagnosing MTC in patients with thyroid nodules who have mild to moderate basal hypercalcitoninemia without an obvious cause.
The researchers selected consecutive patients with nodular thyroid disease undergoing routine measurement of basal calcitonin. They included patients with basal calcitonin higher than 10 pg/ml but lower than 100 pg/ml. A total of 60 patients were recruited (20 men and 40 women).
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“For calcitonin and procalcitonin measurement, the patients were asked to abstain from alcohol for at least one week and to discontinue the use of proton pump inhibitors for at least 4 weeks,” the authors of the study wrote. They collected serum samples at 8 AM in the morning after an 8- to 10-hour fast.
The results demonstrated that procalcitonin was not superior to basal calcitonin in the diagnosis of MTC in the group of patients mentioned. The sensitivity, specificity, negative predictive value, and positive predictive value of procalcitonin in the cohort studied were 100%, 90.2%, 100%, 64.2%, and 91.7% respectively; for basal calcitonin, the values were 100%, 82.3%, 100%, 50%, and 85% respectively.
“More studies are necessary to specifically assess the sensitivity of procalcitonin in patients with MTC and mild hypercalcitoninemia (≤20 pg/ml) and its specificity in patients without MTC with higher calcitonin concentrations (≥50 pg/ml),” Rosario and Mourão concluded.
Rosario PW, Mourão GF. Diagnostic utility of procalcitonin for sporadic medullary thyroid carcinoma in patients with nodular disease and mild or moderate hypercalcitoninemia. Horm Metab Res. 2022;54(4):220-223. doi:10.1055/a-1773-1127