Silva O L, Snider R H, Moore C F, Becker K L
Ann Surg. 1979 Mar;189(3):269-74. doi: 10.1097/00000658-197903000-00002.
Although the radioimmunoassay of serum calcitonin (CT) has facilitated the diagnosis of medullary thyroid cancer (MTC) one may encounter patients whose basal serum levels of CT are normal or nearly normal. In such cases clinicians have utilized intravenous stimulation tests such as calcium or pentagastrin to obtain a diagnostic increase in serum CT. We have reported finding immunoreactive CT in the urine of man and have found it to be a useful technique for the diagnosis and study of patients at risk for MTC or other hypercalcitonemic diseases. Using basal urine CT alone we were able to separate 73% of patients at risk for MTC into clearly normal or abnormal groups. For the remaining 27% a stimulation test with subsequent determination of urine CT was required. The radioimmunoassay of urine CT is a simple, reliable, accurate test for the screening diagnosis of MTC. A protocol for the screening workup of a patient at risk for MTC is given.
尽管血清降钙素（CT）的放射免疫测定法有助于甲状腺髓样癌（MTC）的诊断，但仍可能遇到基础血清CT水平正常或接近正常的患者。在这种情况下，临床医生会采用静脉刺激试验，如钙或五肽胃泌素，以获得血清CT的诊断性升高。我们曾报道在人的尿液中发现免疫反应性CT，并发现它是诊断和研究MTC或其他高降钙素血症疾病高危患者的有用技术。仅使用基础尿CT，我们就能将73%的MTC高危患者分为明显正常或异常组。对于其余27%的患者，则需要进行刺激试验并随后测定尿CT。尿CT的放射免疫测定法是一种用于MTC筛查诊断的简单、可靠、准确的检测方法。本文给出了MTC高危患者筛查检查的方案。
