Procalcitonin as a postoperative marker in the follow-up of patients affected by medullary thyroid carcinoma

Trimboli, Pierpaolo; Lauretta, Rosa; Barnabei, Agnese; Valabrega, Stefano; Romanelli, Francesco; Giovanella, Luca; Appetecchia, Marialuisa

doi:10.1177/1724600817747518

Cited by 21 publications

(16 citation statements)

References 20 publications

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“…From which a review of titles, abstracts, and full texts, 84 articles were excluded. Eight articles were initially eligible for the meta-analysis, and their full text was evaluated [ 12 13 14 15 16 17 18 19 ]. Two articles were excluded due to not available data [ 12 ], and because they used a not commercialized ProCT test, different from that of the other articles [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two articles were excluded due to not available data [ 12 ], and because they used a not commercialized ProCT test, different from that of the other articles [ 13 ]. Among the remaining six studies, one was excluded for overlapping data [ 16 ], five were finally included in the meta-analysis [ 14 15 17 18 19 ]. Fig.…”

Section: Resultsmentioning

confidence: 99%

“…A study by Walter et al [ 17 ] evaluated 69 REC MTC patients and found that ProCT was detectable in 67/69. In the most recently published paper [ 19 ], ProCT showed good performance detecting 11/12 REC and identifying 42/43 NED. Table 1 illustrates the results of the included papers.…”

Section: Resultsmentioning

confidence: 99%

“…Both findings should indicate that ProCT performance in managing MTC patients after their initial treatment is excellent. Some of these studies suggested that ProCT should be used in combination to CT, especially in patients with mild to moderate increase of CT levels or those with inconsistent or fluctuating CT levels [ 14 18 19 ]. In particular, in the study by Algeciras-Schimnich et al [ 14 ], there were 91 MTC (eight newly diagnosed MTC, 40 MTC with detectable stable postoperative CT, and 43 MTC with structural recurrence), both CT and ProCT detected 83 of these 91, there were seven cases missed by CT and other seven missed by ProCT but one case was missed by both tests.…”

Section: Discussionmentioning

confidence: 99%

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Procalcitonin as Marker of Recurrent Medullary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

Trimboli

Giovanella

2018

Endocrinol Metab

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BackgroundCalcitonin measurement is pivotal in the management of medullary thyroid carcinoma (MTC), but several pitfalls can affect its reliability. Other potential markers have been proposed, and procalcitonin (ProCT) has been reported as promising. The present study was undertaken to summarize the published data and provide more robust estimates on the reliability of ProCT as marker in the management of patients with MTC.MethodsThe systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The sources comprised studies published through May 2018. Original articles that reported series of MTC patients undergone ProCT during postoperative follow-up were searched. A random-effects model was used for statistical pooling of the data. The I2 index was used to quantify the consistency among the studies. The Egger test evaluated the possible presence of significant publication bias. Quality assessment of the studies was performed according to Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2).ResultsAccording to inclusion and exclusion criteria five papers, reporting 296 MTC patients undergone ProCT evaluation, were finally selected. The number of MTC with recurrence was 140. The pooled sensitivity of ProCT in detecting recurrence was 96% (95% confidence interval [CI], 92% to 99%), with neither heterogeneity (I2=0%) nor publication bias (Egger test, 3.16; P=0.99). The pooled specificity was 96% (95% CI, 87% to 100%) with mild heterogeneity (I2=66.6%), while Egger test was not calculable.ConclusionThe present meta-analysis provides evidence that ProCT is reliable to manage MTC patients during their postoperative follow-up.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Procalcitonin as Marker of Recurrent Medullary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

Trimboli

Giovanella

2018

Endocrinol Metab

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“…Procalcitonin (PCT) is a precursor of calcitonin that is mainly secreted from thyroid cells, [ 1 ] and it is rapidly produced in response to microbial toxins and inflammatory mediators. Due to its high specificity and sensitivity, PCT was established as an infectious biomarker several decades ago and is mainly used to diagnose and evaluate bacterial infections in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Elevated procalcitonin levels in primary hepatic neuroendocrine carcinoma

Han

Zhong²,

Hong³

et al. 2020

Medicine

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Rationale: Procalcitonin (PCT) has been identified as a tumor biomarker in medullary thyroid carcinoma. Other neuroendocrine carcinomas with elevated PCT levels are relatively rare, and are mainly reported in the lung, digestive tract, and pancreas. No studies in the literature have reported a case of primary hepatic carcinoma complicated with unexpectedly elevated PCT levels. Patient concerns: A 78-year-old man with persistent fatigue and mild fever was complicated with an extremely high PCT level. Radiological examination revealed a single hypodense lesion in the left lobe of the liver with a “rapid enhancement and rapid washout” pattern. Pathological analysis showed a poorly differentiated neuroendocrine carcinoma (grade 3) with multiple genetic mutations. Diagnosis: Primary hepatic neuroendocrine carcinoma. Interventions: The patient received antibiotic therapy and subsequent transcatheter hepatic arterial chemoembolization; a PCT assessment and computed tomography were performed during the follow-up. Outcomes: The PCT level did not decline after antibiotic therapy but greatly declined in response to effective transcatheter hepatic arterial chemoembolization. The patient survived and is still being followed up. Lessons: An extremely elevated PCT level may raise a suspicion of a neuroendocrine carcinoma and plays an indicative role as a biomarker during therapy.

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Sporadisches medulläres Schilddrüsenkarzinom

Thomusch¹,

Machens²

2021

Springer Reference Medizin

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Procalcitonin as a postoperative marker in the follow-up of patients affected by medullary thyroid carcinoma

Abstract: Procalcitonin is reliable in discriminating medullary thyroid carcinoma patients with active disease from those with no evidence of disease. We suggest using procalcitonin as complementary to calcitonin to follow-up medullary thyroid carcinoma patients.

Cited by 21 publications

References 20 publications

Procalcitonin as Marker of Recurrent Medullary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

Procalcitonin as Marker of Recurrent Medullary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

Elevated procalcitonin levels in primary hepatic neuroendocrine carcinoma

Sporadisches medulläres Schilddrüsenkarzinom

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