ECE2019 Poster Presentations Thyroid 2 (70 abstracts)
Cut-off values for basal and calcium stimulated calcitonin for the diagnosis of precocious medullary thyroid carcinoma
Mara Băetu 1, , Cristina Alexandra Olariu 1 , Cristina Stancu 1 , Ruxandra Dobrescu 1, , Gabriel Moldoveanu 1 , Cristina Corneci 1 , Andra Caragheorgheopol 1, , Dumitru Ioachim 1 & Corin Badiu 1,
1‘I. Parhon’ National Institute of Endocrinology, Bucharest, Romania; 2‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania.
Introduction: Thresholds of basal (bCT) or stimulated serum calcitonin (sCT) levels for the diagnosis of medullary thyroid carcinoma (MTC) aren’t specified in current revised MTC guidelines.
Objective: We aim to setfemale (F) specific thresholds for bCT and sCT for MTC diagnosis.
Methods: CT samples were measured during calcium-stimulation test (25 mg/kg BW adapted to ideal body mass index) before and at 2, 5 and 10 minutes after administration of calcium gluconate in 34F with thyroid nodules before thyroidectomy. The analysis involved2 1F with abnormal bCT (>9.82 pg/ml) and a control group of 13F with normal bCT (<9.82 pg/ml). Median age was 45.5 years (23–69). CT was measured by immunochemiluminescence. bCT and sCT were correlated to histological results.
Results: The test had minimum side-effects and was well-tolerated. In the control group, the mean bCT was 2.35±2.71 pg/ml (range:<1-9.23) and the mean peak-sCT was 38.83±54.46 pg/ml (range:1.02-167). We identified 1-MTC (sCT=42.66 pg/ml), 1-macro-papillary thyroid carcinoma (PTC), 3 micro-PTC and 8-benign lesions. For the 21 patients with abnormal bCT, the mean bCT and mean peak-sCT were: 27.54±27.42 pg/ml (range: 9.85–104.4), and respectively 371.24±225 pg/ml (range: 33.16–881.6). We identified: 9-MTC (associated with PTC in 3 cases), 2-macro-PTC, 6-micro-PTC, 1-C-cell hyperplasia (CCH), 3-benign lesions. The best thresholds to discriminate MTC or CCH from the other pathologies and normal subjects were: 13.15 pg/ml for bCT (sensitivity 82%; specificity 70%), AUC 0.85 (CI:0.71-1), P=0.001, and 208.2 pg/ml for sCT (sensitivity 80%; specificity 74%), AUC 0.82 (CI:0.67-0.98), P=0.004. Interestingly enough, the cut-off of 208 remains if we also want to discriminate patients with either MTC, CCH or macro-CPT from other cases. Other pathology results are awaited. Sex specific differences and genetic data are the subject of future reports.
Conclusions: Our study identified bCT and sCT thresholds for distinguishing MTC or CCH for female subjects. The calcium stimulation test is safe to use. Larger groups studies are needed to enhance diagnosis of early stages of MTC, and interestingly enough, maybe also of macro-PTC.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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