The value of routine measurement of serum calcitonin on insufficient, indeterminate, and suspicious thyroid nodule cytology

  • Muhammed Erkam Sencar Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey https://orcid.org/0000-0001-5581-4886
  • Sema Hepsen Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
  • Murat Çalapkulu Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey https://orcid.org/0000-0002-7445-2275
  • Hayri Bostan Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey https://orcid.org/0000-0002-4957-9856
  • Davut Sakiz Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
  • Ilknur Ozturk Unsal Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey https://orcid.org/0000-0003-3999-6426
  • Hakan Duger Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
  • Muhammed Kizilgul Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey https://orcid.org/0000-0002-8468-9196
  • Bekir Ucan Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
  • Tugba Taskin Turkmenoglu Department of Pathology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey https://orcid.org/0000-0001-6314-2928
  • Mustafa Ozbek Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
  • Erman Cakal Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey https://orcid.org/0000-0003-4455-7276
Keywords: Nodular thyroid disease, calcitonin, medullary thyroid cancer, cytology

Abstract

Routine calcitonin measurement in patients with nodular thyroid disease is rather controversial. The aim of this study was to evaluate the contribution of serum calcitonin measurement in the diagnostic evaluation of thyroid nodules with insufficient, indeterminate, or suspicious cytology. Out of 1668 patients who underwent thyroidectomy with the diagnosis of nodular thyroid disease and were screened, 873 patients with insufficient, indeterminate, or suspicious fine needle aspiration biopsy results were included in the study. From the total number of patients in this study, 10 (1.1%) were diagnosed as medullary thyroid cancer (MTC) using histopathology. The calcitonin level was detected to be above the assay-specific cut-off in 23 (2.6%) patients ranging between 6.5 - 4450 pg/mL. While hypercalcitoninemia was detected in all 10 MTC patients, a false positive elevation of serum calcitonin was detected in 13 patients (1.5%). Of the MTC group, 7 patients had cytology results that were suspicious for malignancy (Bethesda V), one patient’s cytology showed atypia of undetermined significance (Bethesda III) and two patient’s cytology results were suspicious for follicular neoplasm (Bethesda IV). Among the cases with non-diagnostic cytology (Bethesda I), none of the patients were diagnosed with MTC. In conclusion, routine serum calcitonin measurement can be performed in selected cases rather than in all nodular thyroid patients. While it is reasonable to perform routine calcitonin measurement in patients with Bethesda IV and Bethesda V, this measurement was not useful in Bethesda I patients. In Bethesda III patients, patient-based decisions can be made according to their calcitonin measurement.

 

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The value of routine measurement of serum calcitonin on insufficient, indeterminate, and suspicious thyroid nodule cytology
Published
2021-05-21
How to Cite
1.
Sencar ME, Hepsen S, Çalapkulu M, Bostan H, Sakiz D, Ozturk Unsal I, Duger H, Kizilgul M, Ucan B, Taskin Turkmenoglu T, Ozbek M, Cakal E. The value of routine measurement of serum calcitonin on insufficient, indeterminate, and suspicious thyroid nodule cytology. Bosn J of Basic Med Sci [Internet]. 2021May21 [cited 2021Jun.24];. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/5756
Section
Translational and Clinical Research