Minoru Kihara1, Akira Miyauchi2, Takumi Kudo3, Mitsuyoshi Hirokawa4, Akihiro Miya2. 1. Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe, Hyogo, 650-0011, Japan. kihara@kuma-h.or.jp. 2. Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe, Hyogo, 650-0011, Japan. 3. Department of Internal Medicine, Kuma Hospital, Kobe, 650-0011, Japan. 4. Department of Diagnostic Pathology, Kuma Hospital, Kobe, 650-0011, Japan.
Abstract
PURPOSE: Calcitonin is the most sensitive tumor marker of medullary thyroid carcinoma (MTC) and a calcium stimulation test is used to improve this sensitivity. In Japan, the electrochemiluminescence immunoassay (ECLIA) is currently the only test performed to measure serum calcitonin. There is a gender difference in the reference value of serum calcitonin; however, a reference upper limit for use with ECLIA has been reported only for women, but not for men. METHODS: We conducted the calcium stimulation test using ECLIA in 21 men with non-medullary thyroid carcinoma (non-MTC), before and after total thyroidectomy. RESULTS: Preoperatively, the basal calcitonin values were within normal limits in all patients. They increased to a mean value of 37.6 pg/mL after calcium stimulation, and we calculated that the reference upper limit was 83.7 pg/mL. The stimulation test results after total thyroidectomy showed undetectable basal and stimulated calcitonin values in every patient (<0.5 pg/mL). CONCLUSIONS: To our knowledge, this is the first study to calculate reference values for this stimulation test using an ECLIA in men with non-MTC. We propose that men can be regarded as biochemically cured or as having normal serum calcitonin values when the stimulated calcitonin values obtained by ECLIA are <83.7 pg/mL before and <0.5 pg/mL after total thyroidectomy.
PURPOSE: Calcitonin is the most sensitive tumor marker of medullary thyroid carcinoma (MTC) and a calcium stimulation test is used to improve this sensitivity. In Japan, the electrochemiluminescence immunoassay (ECLIA) is currently the only test performed to measure serum calcitonin. There is a gender difference in the reference value of serum calcitonin; however, a reference upper limit for use with ECLIA has been reported only for women, but not for men. METHODS: We conducted the calcium stimulation test using ECLIA in 21 men with non-medullary thyroid carcinoma (non-MTC), before and after total thyroidectomy. RESULTS: Preoperatively, the basal calcitonin values were within normal limits in all patients. They increased to a mean value of 37.6 pg/mL after calcium stimulation, and we calculated that the reference upper limit was 83.7 pg/mL. The stimulation test results after total thyroidectomy showed undetectable basal and stimulated calcitonin values in every patient (<0.5 pg/mL). CONCLUSIONS: To our knowledge, this is the first study to calculate reference values for this stimulation test using an ECLIA in men with non-MTC. We propose that men can be regarded as biochemically cured or as having normal serum calcitonin values when the stimulated calcitonin values obtained by ECLIA are <83.7 pg/mL before and <0.5 pg/mL after total thyroidectomy.
Authors: Samuel A Wells; Sylvia L Asa; Henning Dralle; Rossella Elisei; Douglas B Evans; Robert F Gagel; Nancy Lee; Andreas Machens; Jeffrey F Moley; Furio Pacini; Friedhelm Raue; Karin Frank-Raue; Bruce Robinson; M Sara Rosenthal; Massimo Santoro; Martin Schlumberger; Manisha Shah; Steven G Waguespack Journal: Thyroid Date: 2015-06 Impact factor: 6.568
Authors: F Milone; V Ramundo; M G Chiofalo; R Severino; I Paciolla; L Pezzullo; G Lombardi; A Colao; A Faggiano Journal: Clin Endocrinol (Oxf) Date: 2009-12-18 Impact factor: 3.478