Endocrine Abstracts (2011) 26 P449

Routine serum calcitonin measurement in screening of medullary thyroid carcinoma (MTC) in Gohierri county

J Marti & M M Galar

Hospital Zumarraga, Zumarraga, Guipuzcoa, Spain.

Introduction: The utility of serum calcitonin has been evaluated in a series of prospective, nonrandomized studies suggest that the use of routine serum calcitonin for screening may detect C-cell hyperplasia and medullary thyroid cancer at an earlier stage and overall survival may be improved. Elisei et al. estimated that routine measurement of plasma calcitonin in thyroid nodule patients would yield an additional 2.2 life-years per positive patient.

Aim: To determine the usefulness in our county of the determination of calcitonin in patients with thyroid nodules disease, to exclude the presence of MTC.

Patients and methods: The study included 434 patients seen in our Department between 2006 and 2009 for nodular thyroid disease, who were screened for MTC by serum CT measurement. The clinical diagnosis, as assessed by clinical examination, thyroid ultrasound, and thyroid function tests, included single nodules, non-toxic multinodular goiter, autonomous functioning thyroid nodules. Fine needle aspiration was performed as a routine procedure. The cost of calcitonin determination was € 15, per sample. Patients with impaired renal function, protons pump inhibitor treatment were been excluded. None of patient had had family with MCT.

Results: We studied 434 patients, 71 men and 361 women (60.29±15.3 years), with multinodular goiter (76.3%) and uninodular (22.7%). They were analyzed a 595 samples of calcitonin, which was normal in all patients (<8 pg/ml). The global cost of calcitonin determination for 4 year was 8925 euros. Surgical proceeding was been performed in 76 patients (compressive goiter, cytology suspicious of malignancy), the diagnosis was 4 papillary carcinoma and benign nodular lesion to the rest of patients, no MCT was found.

Conclusion: In our study, the analysis of calcitonin was normal in all patients, despite in our study we have not found any MCT we believe that calcitonin measurement is an useful test with low cost in early diagnosis of MCT.

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