Karges W
Universitätsklinikum Aachen, RWTH Aachen, Aachen.
Chirurg. 2010 Jul;81(7):620, 622-6. doi: 10.1007/s00104-009-1883-9.
Calcitonin is considered to be a sensitive marker for medullary thyroid cancer (MTC) therefore early detection and surgical treatment may help to improve the clinical prognosis of MTC. Routine calcitonin measurement has therefore been recommended in the diagnostic evaluation of patients with nodular thyroid disease. In the case of elevated serum calcitonin (>20 pg/ml) stimulation testing is recommended to improve the predictive power for MTC particularly in patients with small nodules. Serum calcitonin measurement cannot reliably discriminate between micro-MTC (<10 mm) and C cell hyperplasia. In patients with stimulated calcitonin levels exceeding 100 pg/ml thyroidectomy is recommended because of a high inherent risk of MTC. Highly elevated basal and stimulated serum calcitonin levels are strongly suggestive of MTC with practical implications for surgical management.
降钙素被认为是甲状腺髓样癌（MTC）的敏感标志物，因此早期发现和手术治疗可能有助于改善MTC的临床预后。因此，在甲状腺结节性疾病患者的诊断评估中，建议进行常规降钙素检测。如果血清降钙素升高（>20 pg/ml），建议进行刺激试验以提高对MTC的预测能力，特别是对于小结节患者。血清降钙素检测不能可靠地区分微小MTC（<10 mm）和C细胞增生。对于刺激后降钙素水平超过100 pg/ml的患者，由于MTC的固有风险较高，建议进行甲状腺切除术。基础和刺激后血清降钙素水平高度升高强烈提示MTC，对手术管理具有实际意义。
