ECE2022 Poster Presentations Thyroid (136 abstracts)
Comparison of serum calcitonin and neck ultrasound sensitivities in identifying medullary thyroid carcinoma
Antonio Matrone , Carla Gambale , Alessandro Prete , Virginia Cappagli , Loredana Lorusso , Valeria Bottici , Paolo Vitti & Rossella Elisei
Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
Background: Serum calcitonin (CT) is a very sensitive test for the diagnosis of medullary thyroid carcinoma (MTC). However, its routine dosage in patients with nodular thyroid disease is not recommended by all scientific societies. In addition, to optimize costs, it is only suggested in the case of suspicious nodules on ultrasound, indeterminate nodules at cytology or nodular goiter before surgery. The aim of the study is to evaluate the serum CT in a series of consecutive MTC divided according to the pre-operative ultrasound risk.
Materials: We evaluated the pre-operative features of 152 consecutive patients surgically treated for MTC (2014-2020). Based on the EU-TIRADS, ATA, AACE/ACE-AME, ACR-TIRADS, and K-TIRADS ultrasound risk stratification systems, we defined 2 groups: Group A (72 pts - 47.4%) with high ultrasound suspicion and Group B (80 pts - 52.6 %) with intermediate-low ultrasound suspicion of malignancy.
Results: The 2 groups did not differ in any epidemiological and clinical features. Pre-operative CT was significantly higher in Group A [369.5 pg/ml (IQR: 84-1718.8)] than Group B [115.5 pg/ml (IQR: 41.5-555)] (P=0.01). Despite this difference CT values were suggestive of MTC in both groups. Moreover, CT values directly correlated with nodule size in both groups. To note, in microcarcinomas, also if not clearly diagnostic of MTC, CT value was above the normal range. FNAC was suggestive for MTC only in 43.3% of Group A and 56.5% of Group B, without significant differences.
Conclusions: Increased pre-operative CT values are confirmed to be highly suggestive of MTC, regardless of the ultrasound suspicion of malignancy, the size of the nodule, and the cytological result.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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