Procalcitonin for detecting medullary thyroid carcinoma: a systematic review

Abstract

The aim of the present study was to perform a systematic review of published studies to provide a robust estimation of the use of procalcitonin (ProCT) as a diagnostic marker of medullary thyroid carcinoma (MTC), with particular focus on its specificity and negative predictive value in excluding MTC. A comprehensive computer literature search was conducted to find relevant published articles on the topic. We used a search algorithm based on a combination of the terms 'medullary,' 'thyroid,' and 'ProCT.' The search was updated until February 2015. To expand our search, references of the retrieved articles were also screened. A total of 39 articles were retrieved, of which nine original papers published from 2003 to 2014 were selected for the review. Some of these studies used ProCT in the preoperative diagnosis of MTC, whereas others measured ProCT during the follow-up of patients who had been previously treated for MTC. Other laboratory measurements were performed in some of the included studies. The results of the majority of the studies indicate that ProCT measurement appears to be a very promising and reliable serum marker for the diagnosis of MTC, and it is not inferior to calcitonin (CT). The sample handling is less laborious, and in the few CT-negative cases reviewed, the assay had even greater sensitivity. It would be worthwhile to establish cutoff levels using larger patient series, because we speculate that this assay could potentially replace CT measurement in the future.

Procalcitonin measurement to screen medullary thyroid carcinoma: A prospective evaluation in a series of 2705 patients with thyroid nodules

“…On the whole, the above-mentioned study results suggested that PCT could be a new standard of care in the management of MTC and, at minimum, is a useful complementary biomarker to exclude MTC in patients with suspicious thyroid nodules or suggestive symptoms. 28 This study was undertaken to prospectively evaluate the diagnostic performance of PCT as the first-line biomarker to screen patients with thyroid nodules for medullary thyroid carcinoma.…”

“Atypical” Non-Secretory Medullary Thyroid Carcinoma: Case Report and Review of the Literature

“…In some cases the carcinoma exhibits diffuse staining for calcitonin [3,13,14], in other cases weak or focal [3,10,15]. In some cases are micro MTC [16] in other metastatic [3]. One could say that not all could be explained by the same theory.…”

“…The past few years the role of pro-calcitonin have been investigated [12,16]. Pro-calcitonin has the same sensitivity and specificity as calcitonin but it is a much more stable and easier to handle molecule than calcitonin [7,16].…”

“…Pro-calcitonin has the same sensitivity and specificity as calcitonin but it is a much more stable and easier to handle molecule than calcitonin [7,16]. Could pro-calcitonin help us when it comes to patients with negative MTC?…”

Nodular Thyroid Disease and Thyroid Cancer in the Era of Precision Medicine

“…Thus, there is a need for accurate markers to rule out MTC in these patients. Some studies have reported better performance of procalcitonin in comparison with CT [73] .…”