术前诊断髓样甲状腺癌时基础及五肽胃泌素刺激后降钙素的截断值。
Basal and pentagastrin-stimulated calcitonin cut-off values in diagnosis of preoperative medullary thyroid cancer.
机构信息
Department of Endocrinology and Metabolism, Erzurum Regional Education and Research Hospital, Erzurum, Turkey
Department of Endocrinology and Metabolism, Ege University Medical Faculty, İzmir, Turkey
出版信息
Turk J Med Sci. 2021 Apr 30;51(2):650-656. doi: 10.3906/sag-2003-182.
BACKGROUND/AIM: Medullary thyroid cancer (MTC) originates from parafollicular cells (C cell) and produces calcitonin (CT). Basal serum CT was used in the diagnosis and treatment of MTC. If basal CT level is 100 pg/mL or higher, it is likely to have MTC, but if basal CT level is below 10 pg/mL, the probability of developing thyroid disease is low. In cases with basal CT level between 10–100 pg/mL, pentagastrin-stimulated (PS) CT level is studied to evaluate MTC and C cell hyperplasia (CHH). This study aimed to determine cut-off value for basal and PS peak CT level for diagnosis of MTC.
MATERIALS AND METHODS
We retrospectively reviewed files of patients presented to endocrine outpatient clinic of Ege University, Medicine School, between 2010 and 2019; 176 patients with basal CT level of 10–100 pg/mL and patients with PS test were included to the study.
RESULTS
The receiver operating characteristic curve (ROC) analysis was used to determine cut-off value for basal CT that can discriminate cases with MTC and those with nodular goiter. Cut-off value for basal CT was calculated as 46.5 pg/mL (specificity; 100 %, sensitivity; 74 %). In the ROC analysis for peak PS CT, cut-off value was calculated as 285 pg/mL (specificity:100 %; sensitivity:82 %). When peak CT level was > 290 pg/mL in PS test, both specificity and sensitivity for MTC were determined as 100 %. The PS peak CT level > 285 pg/ mL was significant for MTC diagnosis while range of 117–274 pg/mL was significant for CHH.
CONCLUSION
In this study, cut-off value was calculated as 46.5 pg/mL for basal CT, whereas 285 pg/mL for PS peak CT in the diagnosis of preoperative MTC.
背景/目的：甲状腺髓样癌 (MTC) 起源于滤泡旁细胞 (C 细胞) 并产生降钙素 (CT)。基础血清 CT 用于 MTC 的诊断和治疗。如果基础 CT 水平为 100 pg/mL 或更高，则可能患有 MTC，但如果基础 CT 水平低于 10 pg/mL，则发生甲状腺疾病的可能性较低。在基础 CT 水平在 10-100 pg/mL 之间的情况下，研究五肽胃泌素刺激 (PS) CT 水平以评估 MTC 和 C 细胞增生 (CHH)。本研究旨在确定基础和 PS 峰值 CT 水平的截断值以诊断 MTC。
材料和方法
我们回顾性审查了 2010 年至 2019 年期间在伊兹密尔大学医学院内分泌门诊就诊的患者的档案；将基础 CT 水平为 10-100 pg/mL 的 176 例患者和接受 PS 测试的患者纳入研究。
结果
使用受试者工作特征曲线 (ROC) 分析确定可以区分 MTC 病例和结节性甲状腺肿病例的基础 CT 截断值。基础 CT 的截断值计算为 46.5 pg/mL（特异性；100%，敏感性；74%）。在 PS 测试中 PS 峰值 CT 的 ROC 分析中，计算出的截断值为 285 pg/mL（特异性：100%；敏感性：82%）。当 PS 测试中 PS 峰值 CT 水平>290 pg/mL 时，MTC 的特异性和敏感性均确定为 100%。PS 峰值 CT 水平>285 pg/mL 对 MTC 诊断具有重要意义，而 117-274 pg/mL 的范围对 CHH 具有重要意义。
结论
在这项研究中，计算出基础 CT 的截断值为 46.5 pg/mL，而 PS 峰值 CT 的截断值为 285 pg/mL，用于术前 MTC 的诊断。
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