Procalcitonin as a postoperative marker in the follow-up of patients affected by medullary thyroid carcinoma

Pierpaolo Trimboli, Rosa Lauretta, Agnese Barnabei, Stefano Valabrega, Francesco Romanelli, Luca Giovanella, Marialuisa Appetecchia

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: Due to the limits of calcitonin, other markers are warranted to better manage medullary thyroid carcinoma patients, and procalcitonin has been reported as promising. Here we aimed to evaluate procalcitonin as a marker of medullary thyroid carcinoma in the post-treatment follow-up. Methods: Medullary thyroid carcinoma patients previously treated by thyroidectomy were enrolled. After complete imaging work-up (i.e. ultrasonography, computed tomography, magnetic resonance and18FDG-PET-CT) we identified patients with structural recurrent/persistent medullary thyroid carcinoma (active medullary thyroid carcinoma) and subjects with no evidence of disease. Then, both calcitonin and procalcitonin were measured and their performance analyzed. Results: The final series included 55 medullary thyroid carcinoma patients treated and followed-up for about five years. Of these, 43 were assessed as no evidence of disease, and 12 as active medullary thyroid carcinoma. The median value of procalcitonin was significantly higher (P < 0.0001) in active medullary thyroid carcinoma patients (3.10 ng/mL) than in those with no evidence of disease (0.10 ng/mL). Also, calcitonin levels of active medullary thyroid carcinoma (96.7 pg/mL) were significantly (P < 0.0001) higher than that of no evidence of disease (2.0 pg/mL). At the receiver operating characteristic curve analysis, the optimal cut-off of procalcitonin was ≥0.32 ng/mL with 92% sensitivity and 98% specificity, while the most accurate threshold of calcitonin was ≥12.0 pg/mL with 100% sensitivity and 91% specificity. There was no active medullary thyroid carcinoma with simultaneously negative results of procalcitonin and calcitonin. Conclusions: Procalcitonin is reliable in discriminating medullary thyroid carcinoma patients with active disease from those with no evidence of disease. We suggest using procalcitonin as complementary to calcitonin to follow-up medullary thyroid carcinoma patients.

Original languageEnglish
Pages (from-to)156-160
Number of pages5
JournalInternational Journal of Biological Markers
Volume33
Issue number2
DOIs
Publication statusPublished - Jan 1 2018

Keywords

  • Calcitonin
  • Medullary thyroid cancer
  • Procalcitonin
  • Thyroid nodule

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Oncology
  • Clinical Biochemistry
  • Cancer Research

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