Utilità e limiti dei markers biologici nella diagnosi dei carcinomi della tiroide

Translated title of the contribution: Useful and limits of the biochemical markers for the diagnosis of thyroid carcinoma

Paolo Colombo, Fabiana Locatelli, Pietro Travaglini

Research output: Contribution to journalArticlepeer-review

Abstract

A series of biochemical parameters are useful for the diagnosis and follow-up of differentiated thyroid carcinomas. The measurement of serum thyroglobulin (Tg) is considered for the post-surgicallradioiodine follow-up ofpapillary!follicular carcinomas. Other than in basal conditions, the importance of Tg levels during TSH stimulation is underlined, either by discontinuation of L-T4 therapy or by recombinant human TSH test. The finding of undetectable Tg levels during TSH stimulation is highly correlated with clinical remission; otherwise, peak Tg levels > 1-2 ng/ml can be suggestive of recurrence/persistence of the disease. The accuracy of Tg measurements for the detection of metastases seems to be higher when compared to 131-1 whole-body scan. The evaluation of basal serum calcitonin levels is recommended for the screening of medullary thyroid carcinoma (MTU). High basal levels suggest the presence of a tumor but a calcitonin increase can be observed also in parafollicular C cell hyperplasia (CCH) and other extra-thyroidal conditions. The pentagastrin test can by pass this obstacle as the calcitonin response seems to be typical of pathological thyroid C cells. The cut-off value of calcitonin response between patients ivith MTC and CCH remains to be established; the latter condition, however, being considered by some authors as pre-cancerous. A fter thyroid surgery the measurement of calcitonin constitutes a valid tool for the detection of cure and/or recurrence of the disease. The screening by means of RET oncogene analysis is also described for patients with MTC with Multiple Endocrine Neoplasia (MEN) type 2 syndrome.

Translated title of the contributionUseful and limits of the biochemical markers for the diagnosis of thyroid carcinoma
Original languageItalian
Pages (from-to)209-214
Number of pages6
JournalAnnali Italiani di Chirurgia
Volume77
Issue number3
Publication statusPublished - May 2006

ASJC Scopus subject areas

  • Surgery

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