OBJECTIVE: Presently, no clinical tools are available to diagnose the metastatic potential of medullary thyroid cancer (MTC) at disease presentation. Surveillance with calcitonin (Ct) and carcinoembryonic antigen (CEA) is currently recommended for the observation and diagnosis of metastatic disease after initial treatment of MTC. Recently, carbohydrate antigen (CA)19-9 staining has been associated with aggressive forms of MTC and metastatic spread. This pilot study explored whether positive CA19-9 staining of MTC tissue is associated with its metastatic potential. METHODS: Sixteen cases of MTC were identified, and tissue specimens were immunostained for CA 19-9 and other MTC tumor markers. Clinical information about patients' MTC was collected through a retrospective chart review. RESULTS: Overall, 63% of the specimens stained positive for CA19-9. The median size of positively staining specimens was 2.6 cm (interquartile range [IQR] 1.2-3.2) compared to 0.7 cm (0.5-1.2) in negatively staining MTC specimens (P = .04). All specimens from patients diagnosed with stage IV MTC stained positive for CA19-9, compared to only 40% of cases that were classified as stages I to III (P = .03). Furthermore, 100% of the primary specimens that were documented to have metastatic spread stained positive for CA19-9. The sensitivity for ruling out stage IV MTC based on negative staining for CA 19-9 was 100%. CONCLUSION: Based on these results, we conclude that negative staining of MTC for CA19-9 may be associated with its decreased metastatic potential.
OBJECTIVE: Presently, no clinical tools are available to diagnose the metastatic potential of medullary thyroid cancer (MTC) at disease presentation. Surveillance with calcitonin (Ct) and carcinoembryonic antigen (CEA) is currently recommended for the observation and diagnosis of metastatic disease after initial treatment of MTC. Recently, carbohydrate antigen (CA)19-9 staining has been associated with aggressive forms of MTC and metastatic spread. This pilot study explored whether positive CA19-9 staining of MTC tissue is associated with its metastatic potential. METHODS: Sixteen cases of MTC were identified, and tissue specimens were immunostained for CA 19-9 and other MTC tumor markers. Clinical information about patients' MTC was collected through a retrospective chart review. RESULTS: Overall, 63% of the specimens stained positive for CA19-9. The median size of positively staining specimens was 2.6 cm (interquartile range [IQR] 1.2-3.2) compared to 0.7 cm (0.5-1.2) in negatively staining MTC specimens (P = .04). All specimens from patients diagnosed with stage IV MTC stained positive for CA19-9, compared to only 40% of cases that were classified as stages I to III (P = .03). Furthermore, 100% of the primary specimens that were documented to have metastatic spread stained positive for CA19-9. The sensitivity for ruling out stage IV MTC based on negative staining for CA 19-9 was 100%. CONCLUSION: Based on these results, we conclude that negative staining of MTC for CA19-9 may be associated with its decreased metastatic potential.
Authors: Shishir K Maithel; Stephen Maloney; Corrine Winston; Mithat Gönen; Michael I D'Angelica; Ronald P Dematteo; William R Jarnagin; Murray F Brennan; Peter J Allen Journal: Ann Surg Oncol Date: 2008-09-10 Impact factor: 5.344
Authors: Penelope M Drake; Wonryeon Cho; Bensheng Li; Akraporn Prakobphol; Eric Johansen; N Leigh Anderson; Fred E Regnier; Bradford W Gibson; Susan J Fisher Journal: Clin Chem Date: 2009-12-03 Impact factor: 8.327
Authors: Anne Laure Giraudet; Abir Al Ghulzan; Anne Aupérin; Sophie Leboulleux; Ahmed Chehboun; Frédéric Troalen; Clarisse Dromain; Jean Lumbroso; Eric Baudin; Martin Schlumberger Journal: Eur J Endocrinol Date: 2008-02 Impact factor: 6.664
Authors: Adam C Berger; Miguel Garcia; John P Hoffman; William F Regine; Ross A Abrams; Howard Safran; Andre Konski; Alan B Benson; John MacDonald; Christopher G Willett Journal: J Clin Oncol Date: 2008-11-24 Impact factor: 44.544