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Endocrine Abstracts (2007) 14 P101

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1Nuclear Medicine, Lille, France; 2Endocrinology, Lille, France; 3Pathology, Lille, France; 4Endocrine Surgery, Lille, France; 5Internal Medicine, Strasbourg, France; 6Endocrinology, Toulouse, France.


Increased basal or pentagastrin-stimulated calcitonin level is the cornerstone for the biological diagnosis of medullary thyroid carcinoma, but is also observed in patients with C-cell hyperplasia (CCH) of the thyroid. In a prospective multicenter study we re-evaluated the reference ranges of basal calcitonin (bCT) in 287 euthyroid controls without thyroid disease (142 men-45 smokers, 3 deprived, 145 women-27 smokers). The CT levels were measured using 2 different assays (Cis-Bio International, Advantage Nichols). After exclusion of the main causes of increased CT levels, 11 (8%) male controls had bCT concentrations >10 pg/mL within the two assays. All, except one, were active or deprived smokers. Then, we evaluated preoperative bCT and pentagastrin-stimulated CT levels in patients with CCH of the thyroid (more than 50 C cells per field at 3 low-power magnification microscopic fields). In 27 smokers or deprived patients (23 men and 4 women, median age 53 years) total thyroidectomy was performed for nodular pathology. CCH was diffuse and bilateral (n=17), diffuse and unilateral (n=4), nodular (n=1) or diffuse and nodular (n=5). Preoperative bCT was normal (<10 pg/mL), between 10 and 20 pg/mL or >20 pg/mL in 8, 13, and 6 patients, respectively. Pentagastrin- stimulated CT level was normal (<50 pg/mL), between 50 and 100 pg/mL, and >100 pg/mL in 2, 3, and 15 patients respectively.

In conclusion, there are evidences that cigarette smoking induces: 1) diffuse and bilateral CCH of thyroid, 2) increased bCT level, 3) abnormal pentagastrin-simulated test, particularly in men.

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