Diagnosis of medullary carcinoma of the thyroid (MCT) by calcitonin assay using monoclonal antibodies: criteria for the pentagastrin stimulation test in hereditary MCT.
A new calcitonin (CT) immunoradiometric assay, using anti-11-7 and anti-24-32 CT fragment monoclonal antibodies was evaluated and compared to classical RIA. The sensitivity was 2.5 ng/L, the normal basal level (n = 83) was lower than 10 ng/L, the response to pentagastrin stimulation in control subjects was absent in nine and between 10-30 ng/L in nine others. (mean, 15.4). In patients with renal failure the basal level was increased between 10-52 ng/L. In patients with medullary thyroid carcinoma (MTC; n = 28), the basal level was between 189-28,900 ng/L. A pentagastrin test was performed as screening for familial MTC in eight patients with confirmed MTC at subsequent surgery; the calcitonin peak was equal or greater than 38 ng/L. Large differences exist between CT levels measured by RIA and immunoradiometric assay. The latter method provides a greater sensitivity to pentagastrin test and allows a better identification of microcarcinoma in hereditary cases of MTC.
Centre Hospitalier Universitaire, Tours, France.
D
D
Guilloteau
R
R
Perdrisot
C
C
Calmettes
J L
JL
Baulieu
P
P
Lecomte
G
G
Kaphan
G
G
Milhaud
J C
JC
Besnard
P
P
Jallet
J C
JC
Bigorgne
D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000032:analysis*; D002116:Calcitonin / Q000032:analysis* / Q000276:immunology; D002277:Carcinoma / Q000235:genetics* / Q000276:immunology / Q000601:surgery; D005260:Female; D006801:Humans; D015592:Immunoradiometric Assay; D008297:Male; D008875:Middle Aged; D010418:Pentagastrin; D011863:Radioimmunoassay; D013960:Thyroid Function Tests; D013964:Thyroid Neoplasms / Q000235:genetics* / Q000276:immunology / Q000601:surgery
D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D002116:Calcitonin; D010418:Pentagastrin