Endocrine Abstracts

Today calcitonin (CT) and carcinoembryonic antigen (CEA) are widely used as markers of medullary thyroid carcinoma (MTC). Postoperative CT and CEA normalization is a favorable prognostic factor. The work was initiated to assess CEA diagnostic and prognostic value before and after surgery in patients with familial medullary thyroid carcinoma (FMTC). Methods: blood serum from 11 patients with FMTC (mean age 27.4 plus/minus 3.2) undergoing total thyroidectomy and lymph node dissection in the central and lateral neck areas was investigated by means of commercially available kits (Immunotech, Czech Republic). Basal CT more 100 picograms per mililitre, stimulated CT more 300 picograms per mililitre and CEA more 10 nanograms per mililitre were considered typical of MTC. Results: preoperative CEA were elevated in 8 (73 persent), the level in patients with regional metastases being higher than in those with none 169.2±8.33 nanograms per mililitre versus 25.7±2.03 nanograms per mililitre. Basal calcitonine levels were elevated in 7 patients (63.6 persent) with mean values 167.2±31.7 picograms per mililitre and correlated with the tumor stage. Following stimulation with pentagastrin peak CT level elevated in all patients with mean value up to 764.5±13.4 picograms per mililitre. With the disease progression the increase of CEA concentration rate was found dependent on time, basal calcitonine levels varying. In following the surgery effect up CEA levels were found stably decreasing to the normal within 10 days in all patients (mean value 5.7±2.1 nanograms per mililitre. CT normalization lacked the stability above requiring more prolonged follow up, from 2 to 18 months. Neither regional nor remote metastases were detected within the follow-up period. Conclusions: in comparison with CT, CEA is more sensitive prognostic marker in following surgery effect up, but it cannot replace the stimulated CT which is more specific and sensitive diagnostic marker in MTC.