Costante Giuseppe, Durante Cosimo, Francis Zélia, Schlumberger Martin, Filetti Sebastiano
University Magna Graecia, Catanzaro, Italy.
Nat Clin Pract Endocrinol Metab. 2009 Jan;5(1):35-44. doi: 10.1038/ncpendmet1023.
An elevated serum calcitonin level is a highly sensitive marker for medullary thyroid carcinoma (MTC) that can be used for screening, differential diagnosis, prognostic assessment, follow-up monitoring, and assessment of treatment response. Nevertheless, additional data are required to definitively support routine measurement of calcitonin levels in the initial work-up of patients with thyroid nodules, mainly because there is no convincing evidence that such testing actually reduces MTC-related mortality. By contrast, the prognostic value of measuring calcitonin levels preoperatively, postoperatively, and during follow-up of patients with MTC is widely acknowledged. Furthermore, determination of calcitonin levels is also used to evaluate the response of MTC to novel forms of systemic treatment, such as tyrosine kinase inhibitors. In this Review, we discuss the key issues surrounding the use of this laboratory test in the clinical management of patients with MTC.
血清降钙素水平升高是甲状腺髓样癌（MTC）的一个高度敏感标志物，可用于筛查、鉴别诊断、预后评估、随访监测以及治疗反应评估。然而，在甲状腺结节患者的初始检查中，还需要更多数据来明确支持常规检测降钙素水平，主要是因为没有令人信服的证据表明这种检测实际上能降低MTC相关死亡率。相比之下，在MTC患者术前、术后及随访期间测量降钙素水平的预后价值已得到广泛认可。此外，降钙素水平的测定还用于评估MTC对新型全身治疗（如酪氨酸激酶抑制剂）的反应。在本综述中，我们讨论了围绕该实验室检测在MTC患者临床管理中的应用的关键问题。
