title: Frequency and relevance of elevated calcitonin levels in patients with neoplastic and nonneoplastic thyroid disease and in healthy subjects.
abstract: Routine measurement of serum calcitonin (CT) has been recently proposed for all patients with neoplastic thyroid disease to detect clinically occult medullary thyroid carcinoma (MTC). Data on the prevalence of elevated CT levels in nonneoplastic thyroid disease or in healthy subjects have not been reported to date. Four hundred and fourteen consecutive patients with suspected thyroid disease and 362 healthy controls underwent thyroid examination with measurement of basal serum CT. Whenever serum CT was 10 pg/ml or more, a pentagastrin (PG) stimulation test was performed. Twenty-eight of 414 patients (6.8%) showed elevated basal serum CT levels, 15 of them with nonneoplastic thyroid disease, and the remaining 13 subjects with neoplastic thyroid disease. Four patients with abnormal PG testing (stimulated CT, > or = 100 pg/ml) were identified. Three of them had biochemical and sonographical evidence of thyroiditis. Elevated basal CT levels were significantly more frequent in patients with Hashimoto's thyroiditis (HT; P < 0.05). One female patient with HT had a 5-mm nodule, which was classified as MTC. None of the 6 out of 362 healthy controls with elevated basal CT (1.7%) presented an abnormal PG test. Our data suggest that basal CT measurements can be of use in the detection/screening of MTC not only in subjects with neoplastic thyroid disorders, but also in patients with immunological evidence of HT. They also confirm earlier reports on the essential value of PG stimulation testing, even when basal plasma CT levels are only modestly elevated, with regard to establishing the diagnosis of MTC or its premalignant associated conditions (micro-MTC and neoplastic C cell hyperplasia).
authors.affiliation: Department of Nuclear Medicin, University of Vienna, A-1090 Vienna, Austria. karanikas@akh-wien.ac.at
authors.forename: Georgios
authors.initials: G
authors.lastname: Karanikas
authors.forename: Abbas
authors.initials: A
authors.lastname: Moameni
authors.forename: Christian
authors.initials: C
authors.lastname: Poetzi
authors.forename: Georg
authors.initials: G
authors.lastname: Zettinig
authors.forename: Klaus
authors.initials: K
authors.lastname: Kaserer
authors.forename: Christian
authors.initials: C
authors.lastname: Bieglmayer
authors.forename: Bruno
authors.initials: B
authors.lastname: Niederle
authors.forename: Robert
authors.initials: R
authors.lastname: Dudczak
authors.forename: Christian
authors.initials: C
authors.lastname: Pirich
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002116:Calcitonin / Q000097:blood*; D018276:Carcinoma, Medullary / Q000097:blood* / Q000175:diagnosis; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010418:Pentagastrin; D012017:Referral and Consultation; D013959:Thyroid Diseases / Q000097:blood* / Q000175:diagnosis; D013964:Thyroid Neoplasms / Q000097:blood* / Q000175:diagnosis; D013966:Thyroiditis / Q000097:blood / Q000175:diagnosis; D013967:Thyroiditis, Autoimmune / Q000097:blood / Q000175:diagnosis
chemical_list: D002116:Calcitonin; D010418:Pentagastrin