Endocrine Abstracts (2012) 29 P1815

Calcitonin levels in washout of cytology needle on thyroid nodule without suspicion of medullary thyroid carcinoma

T. Martin, C. Garcia, N. Gonzalez, P. Sanchez, A. Barco, V. Martin & A. Sendon

University Hospital Virgen Macarena, Seville, Spain.

Introduction: We study the calcitonin levels measurement in the washout of FNAB needles after sampling each thyroid nodule (FNAB-CT) as an approach to calcitonin normal value in them and distinguish of MTC and to correlate with serum CT (sCT) and cytology FNAB.

Material & Methods: 109 consecutive subjects (mean age 53.7±13.4, range 18–85 yr, 79.8% females, 27.5% smokers, 18.3% autoimmune thyroid disease) initially no suspicious for MTC who underwent FNAB for thyroid nodule served as study poblation (mean size 20.1±9.3 mm.) FNAB was performed in thyroid nodule and the same needle and syringe used for FNAB was washed with 1 mL of % 0.9 sodium chloride solution and sent to the laboratory for calcitonin evaluation (FNAB-CT). Both serum and washout calcitonin were measured by chemiluminescence assay (IMMULITE 2000)

Results: In patients with a thyroid nodule under evaluation, sCT were 3.07±3.22 ng/l (range 2–19.4 ng/l) and and FNAB-CT values 3.98±10.36 ng/l (range 2–97 ng/l), respectively. In 2 patients, FNAB-CT values were 10x higher than the highest values found, but cytology results were compatible with a benign thyroid lesion and papillary carcinoma; both were submitted to surgery found MTC (serum CT/FNAB-CT: 382/32.250 ng/ml, respectively) and microMTC/C-Cell hyperplasia (serum CT/FNAB-CT: 4.5/1.150 ng/ml, respectively) In the other cases FNAB-CT values not show significative correlation with any study parameters (age, sex, autoimmune thyroiditis, tobacco, BMI) except weakly with sCT (r: 0.17, P<0.04).

Conclusion: Assaying calcitonin (CT) in the wash-out fluid from fine-needle aspiration biopsies (FNAB.CT) can be an additional and precocious approach to diagnosis of MTC

Values are expressed as mean±DE and range. sCT (serum calcitonin) nCT (calcitonin in thyroid nodule FNAB-washout)

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector

Table 1 Levels of sCT & nCT in relation to ecographic and cytological diagnostics
Thyroid single nodule (n=39)2.49±1.33 (2–8.1)6.36±16.3 (2–97)
Multinodular Goitre (n=42)3.79±4.6 (2–19.4)2.02±0.02 ( 2–2.1)
Cystic lesion (n=11)4.48±5.26 (2–19.4)≤2
Autoimmune Disease (n=16)2.6±1.15 (2–6.5)3.59±1.15 (2–13.2)
Follicular neoplasm (n=4)2.27±0.55 (2–3.10)3.95±3.0 (2–8.4)
Papillary Cancer (n=4)≤2≤2
Material hematic (n=5)2.6±1.34 (2–5)2.31±0.77 (2–3.9)

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