Niccoli P, Conte-Devolx B, Lejeune P J, Carayon P, Henry J F, Roux F, Wion-Barbot N, Bigorgne J C
Service d'Endocrinologie-Maladies Métaboliques, CHU, Angers.
Ann Endocrinol (Paris). 1996;57(1):15-21.
Serum calcitonin (CT) assays are the most useful tumoral marker for the diagnosis and follow up of medullary thyroid carcinoma (MTC). Since 1988 the sensitivity and specificity of CT assays have been considerably improved. Normal basal and pentagastrin (Pg) stimulated CT ranges remain to be established and it appears necessary to determine the pathological circumstances which may be responsible for hypercalcitoninemia in addition to MCT. By reviewing literature and data from the "Groupe d'Etude des Tumeurs à Calcitonine": a/we compared basal and Pg stimulated CT values obtained with two commercially available immunometric CT assays and we observed that CT values measured by the CT-EASIA MEDGE-NIX kit were three fold the values obtained by suing the hGH ELSA CIS BIOINDUSTRIE Kit; b/we determined that hypercalcitoninemia may be observed in isolated C Cell Hyperplasia (HCC) surrounding either lymphocytic thyroiditis or follicular thyroid carcinoma loci, in chronic renal failure on maintenance hemodialysis, and in various neuroendocrine tumors. Surprisingly, the hypercalcitoninemia related to HCC has been found in genetically unaffected members (without any identified gene RET mutation) of both a Multiple Endocrine Neoplasia type 2A and isolated familial hereditary MTC.
血清降钙素(CT)检测是甲状腺髓样癌(MTC)诊断及随访中最有用的肿瘤标志物。自1988年以来,CT检测的敏感性和特异性有了显著提高。正常基础及五肽胃泌素(Pg)刺激后的CT范围仍有待确定,而且除了MCT外,似乎有必要确定可能导致高降钙素血症的病理情况。通过回顾文献及“降钙素肿瘤研究小组”的数据:a/我们比较了两种市售免疫测定CT检测方法所获得的基础及Pg刺激后的CT值,我们观察到,使用CT-EASIA MEDGE-NIX试剂盒测得的CT值是使用hGH ELSA CIS BIOINDUSTRIE试剂盒所获值的三倍;b/我们确定,在淋巴细胞性甲状腺炎或滤泡性甲状腺癌灶周围的孤立性C细胞增生(HCC)、维持性血液透析的慢性肾衰竭以及各种神经内分泌肿瘤中可能观察到高降钙素血症。令人惊讶的是,在2A型多发性内分泌腺瘤病和孤立性家族遗传性MTC的未受基因影响成员(未发现任何RET基因突变)中均发现了与HCC相关的高降钙素血症。