Does Testosterone Influence the Post‐stimulatory Levels of Calcitonin in Normal Men?

Garcia-Ameijeiras, Angeles; Torre, W.; Rodrı́guez-Espinosa, José; PEREZ‐PEREZand, A.; Leiva, Alberto de

doi:10.1111/j.1365-2265.1987.tb01184.x

Cited by 12 publications

(8 citation statements)

References 16 publications

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“…The reason for the higher peak response in males is not known although androgens might be implicated. The basal CT levels and peak CT values in our study showed no significant correlation with the serum-free testosterone levels in our male controls, which does not agree with that reported by others (19).…”

Section: Discussioncontrasting

confidence: 99%

Experience with a provocative test of calcitonin release as a prospective screening for preclinical medullary thyroid carcinoma in men type 2A family members

Lathem

Vermaak

Kuyl

et al. 1992

Clinical Laboratory Analysis

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We report our experience with a provocative test of calcitonin (CT) release using a combined stimulus of intravenous 10% CaCl2 solution and pentagastrin on 34 normal adults (15 females: age 41 +/- 12.3 years and range 22-65 years; and 19 males: age 43 +/- 9.1 years and range 23-60 years) and in 44 family members of three proven multiple endocrine neoplasia type 2A syndrome (MEN 2A) patients. A commercial radioimmunoassay was used to determine the serum CT levels. Peak CT levels were reached within 2 to 5 minutes after administration of the stimulus in all subjects tested. In the group of normal subjects there was no significant difference in the mean basal CT levels between males (54.8 +/- 21.7 pg/ml) and females (56.5 +/- 34.8 pg/ml), whilst the mean peak response values for males was 146.3 +/- 120.6 pg/ml, which was significantly different from the mean value of females, namely 71.6 +/- 39.0 pg/ml. We did not find significant correlations between the basal CT level, peak CT response, and age. Of the 44 family members tested, 9 showed an exaggerated CT response to the combined stimulus and subsequently had a total thyroidectomy. Histological examination confirmed C-cell hyperplasia (CCH) in one and medullary thyroid carcinoma (MTC) in the other 8. Three of the 9 had high basal plasma CT levels. The 9 patients were retested postoperatively and all showed a flat response to the combined stimulus. Those family members with histological proof of MTC or CCH were screened for genetic linkage to the disease gene for MEN 2A using probe MCK2, and showed correlation in each instance.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussioncontrasting

confidence: 99%

Experience with a provocative test of calcitonin release as a prospective screening for preclinical medullary thyroid carcinoma in men type 2A family members

Lathem

Vermaak

Kuyl

et al. 1992

Clinical Laboratory Analysis

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“…Yang et al (24) have shown that MTC cells in culture were mildly stimulated by estrogens and inhibited by tamoxifen, thus suggesting the expression of estrogen receptors (ER) in MTC cells, but the expression of ER by normal human C-cells has not been demonstrated (25). This may suggest the role of other sex-steroid hormones and/or receptors: in this regard, Garcia-Ameijeiras et al (26) have proposed that testosterone might influence CT secretion in man. As emphasized by Albores-Saavedra and Krueger (1), many more studies are needed to clarify the etiopathogenesis of physiologic (and particularly sex-associated) CCH.…”

Section: Discussionmentioning

confidence: 99%

C-Cell Hyperplasia and Medullary Thyroid Carcinoma: Clinicopathological and Genetic Correlations in 66 Consecutive Patients

et al. 2003

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Routine calcitonin (CT) assay programs and genetic testing for RET proto-oncogene mutations have consistently modified the management and understanding of C-cell proliferative disorders. We report a series of 66 consecutive patients with C-cell hyperplasia (CCH) or medullary thyroid carcinoma (MTC) observed in our institution within an 8-year time period. All the patients had a preoperative basal CT assay and an RET proto-oncogene sequencing. Seventeen patients (F-M ratio: 8:9, mean age: 29.7 y) had a multiple endocrine neoplasia Type 2: 3 children <10 years of age had CCH only, and 14 patients had an MTC, with neoplastic CCH in 10/14 cases. Twenty-seven patients (F-M ratio: 18:9, mean age: 56.6 y) had a sporadic MTC, with physiological CCH in 8 and neoplastic CCH in 3 cases. Twenty-two men (mean age: 46.2 y) had CCH only (physiological CCH in 17 men and neoplastic CCH in 5). We conclude that (1) clinical and pathological characteristics (familial MTC, tumor multifocality, neoplastic CCH) usually associated with hereditary MTC may be misleading and that on the contrary, RET sequencing gives no false positive result; (2) sporadic neoplastic CCH accompanies (and probably precedes) a number of sporadic MTC; and (3) women presenting with a sporadic elevated basal CT have a 100% risk of having an MTC (15/15), but this risk is 3-fold less in men (31%), who will most often have CCH only (69%).KEY WORDS: C-cell hyperplasia, Gender, Medullary thyroid carcinoma, Microcarcinoma, RET. Mod Pathol 2003;16(8):756 -763Medullary thyroid carcinoma (MTC) is a rare neoplasm, which is hereditary in 25% of the cases, in multiple endocrine neoplasia Type 2 (MEN 2) families (1). During the past 10 years, two major tests have modified the current approach and presentation of MTC. First of all, the development of calcitonin (CT) screening programs in routine endocrinological practice has proven to be effective in the early detection of a number of MTCs (2-4). As a consequence, pathologists have been confronted with a dramatic increase in micro-MTC diagnosis ratio, as illustrated by recent series (5-7). On the other hand, this routine biological screening has also been responsible for the detection of an increasing number of patients presenting with C-cell hyperplasia (CCH) only (3,8), in which thyroidectomy might be considered unjustified. Moreover, a highly sensitive and specific genetic test is now available to identify the germline mutations of the proto-oncogene RET in affected members of MEN 2 families. In MEN 2, MTC is characterized by a high penetrance (Ͼ90%; 9), and since 1997 there has been a consensus that the decision to perform a thyroidectomy should be based predominantly on the result of genetic testing (10). Therefore, affected children with a positive genetic testing are now often treated at a preneoplastic stage, called neoplastic CCH or in situ MTC (1,11,12). In this study, we describe the clinicopathologic features of a series of MTC and CCH cases with complete biological and genetic testing, with emphasis on the pract...

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“…In 1987, Garcia-Ameijeras et al [10] analyzed the relationship between basal and poststimulatory calcitonin levels and free testosterone and concluded that the elevated calcitonin levels and enhanced response found in normal men compared to normal women were influenced by the higher testosterone levels found among men. Although our findings showed a tendency to increased expression of AR in men (61% vs 33%), our CCH series was probably too small to reach statistical significance.…”

Section: Discussionmentioning

confidence: 97%

“…Very little information is available regarding possible sex steroid hormone regulation of both pathological and normal C cells, or regarding possible differential gender expression. Some authors have shown that estrogens and progesterone could influence in vitro and in vivo calcitonin secretion and stimulate MTC cell growth in culture [13,43], and others have suggested that testosterone might also influence calcitonin secretion in men [10]. Zhai et al [44] found using immunohistochemistry that AR was expressed in 80% of 45 MTC and 2 of 8 CCH in men.…”

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confidence: 99%

Expression of sex steroid hormone receptors in C cell hyperplasia and medullary thyroid carcinoma

et al. 2007

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Previous studies have shown that C cells are twice as numerous in male than in female thyroids and that C cell hyperplasia (CCH) is much more frequent in men. These findings suggest regulation involving sex steroid hormones through the expression of sex steroid hormone receptors on C cells. To investigate this hypothesis, we performed an immunohistochemical study of estrogen receptors alpha (ER alpha) and beta (ER beta), progesterone receptors (PR), and androgen receptors (AR) on specimens from a series of 40 patients operated on for a medullary thyroid carcinoma (MTC; n=28; female 18, male 10) and/or CCH (n=19; female 6, male 13). ER beta was the only receptor to be consistently expressed in CCH (100%) and MTC (96.5%), whereas ER alpha was never expressed. PR and AR were rarely expressed in MTC (7 and 14%, respectively). AR was expressed in half the CCH cases (53%), with a trend to male predominance (61% in men vs 33% in women). Our study is the first to describe ER beta expression in CCH. In addition, our findings suggest that CCH, and possibly MTC, might be influenced by sex steroid hormones, namely, estrogens and androgens, through the expression of ER beta and AR on C cells.

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Does Testosterone Influence the Post‐stimulatory Levels of Calcitonin in Normal Men?

Cited by 12 publications

References 16 publications

Experience with a provocative test of calcitonin release as a prospective screening for preclinical medullary thyroid carcinoma in men type 2A family members

Experience with a provocative test of calcitonin release as a prospective screening for preclinical medullary thyroid carcinoma in men type 2A family members

C-Cell Hyperplasia and Medullary Thyroid Carcinoma: Clinicopathological and Genetic Correlations in 66 Consecutive Patients

Expression of sex steroid hormone receptors in C cell hyperplasia and medullary thyroid carcinoma

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