title: Biochemical markers in the follow-up of medullary thyroid cancer.
abstract: Medullary thyroid cancer (MTC) shares biochemical features with other neuroendocrine tumors but the particular characteristics are largely unexplored. We investigated the biochemical neuroendocrine profile of MTC and whether specific markers could be useful in follow-up. In addition to the standard tumor marker calcitonin, plasma carcino-embryonic antigen (CEA), plasma catecholamines, (platelet) serotonin, chromogranin A, tryptase, and urinary markers of catecholamine, histamine, and serotonin metabolism were prospectively determined in 46 patients with histologically proven MTC. Patients were divided according to the stage of disease: group 1, no evidence; group 2, stable disease (SD); and group 3, progressive disease (PD). Plasma dopamine was increased in the majority of the patients with SD and PD; however it did not correlate with extent of disease. Elevated plasma platelet levels of serotonin were only present in patients with multiple endocrine neoplasia 2 with SD or PD but did not differ between those groups. Histamine metabolites were elevated in 20% of patients with SD and PD. In addition to plasma calcitonin, only CEA and chromogranin A could differentiate between stable and progressive MTC. MTCs are capable of synthesizing catecholamines, serotonin, and histamine metabolites underscoring that MTCs have metabolic characteristics in common with other neuroendocrine tumors. Thus far, clinical usefulness and relevance seems limited. The most useful markers in the follow-up of MTC are plasma calcitonin and CEA.
authors.affiliation: Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, the Netherlands.
authors.forename: Jan Willem B
authors.initials: JW
authors.lastname: de Groot
authors.forename: Ido P
authors.initials: IP
authors.lastname: Kema
authors.forename: Henk
authors.initials: H
authors.lastname: Breukelman
authors.forename: Eveline
authors.initials: E
authors.lastname: van der Veer
authors.forename: Theo
authors.initials: T
authors.lastname: Wiggers
authors.forename: John T M
authors.initials: JT
authors.lastname: Plukker
authors.forename: Bruce H R
authors.initials: BH
authors.lastname: Wolffenbuttel
authors.forename: Thera P
authors.initials: TP
authors.lastname: Links
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D001792:Blood Platelets / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D018276:Carcinoma, Medullary / Q000378:metabolism*; D002395:Catecholamines / Q000097:blood / Q000652:urine; D053379:Chromogranin A / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006632:Histamine / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D018813:Multiple Endocrine Neoplasia Type 2a / Q000378:metabolism*; D011446:Prospective Studies; D012701:Serotonin / Q000378:metabolism / Q000652:urine; D013964:Thyroid Neoplasms / Q000378:metabolism*; D053802:Tryptases / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D002395:Catecholamines; D053379:Chromogranin A; D012701:Serotonin; D006632:Histamine; D002116:Calcitonin; D053802:Tryptases