Calcium stimulated calcitonin measurement: a procedural proposal

Exp Clin Endocrinol Diabetes. 2013 May;121(5):318-20. doi: 10.1055/s-0033-1333686. Epub 2013 Feb 21.

Abstract

Human calcitonin (hCT) is a tumor marker essential to the diagnosis and follow-up of medullary thyroid cancer (MTC). Current consensus recommends hCT measurement when initially evaluating thyroid nodules; if slightly elevated, a confirmatory stimulated calcitonin test is commonly performed, usually using pentagastrin. In recent years the supply of pentagastrin was not guaranteed with long periods of unavailability; the outlook for future availability is unknown. Therefore it is desirable for many institutions to establish a procedure for calcitonin stimulation using a stimulant with a secure supply; stimulation of calcitonin using calcium represents the easiest alternative.Several schemes and dosages have been used in the past for calcium stimulated calcitonin measurement. In this paper we propose a procedure for calcium stimulated calcitonin measurement based on our experiences. Furthermore we will briefly point out the limitations of this method with regard to available data in literature.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / blood
  • Biomarkers, Tumor / metabolism
  • Calcitonin / analysis*
  • Calcitonin / blood
  • Calcitonin / metabolism
  • Calcium / pharmacology
  • Carcinoma, Neuroendocrine
  • Humans
  • Pentagastrin / analysis
  • Pentagastrin / blood
  • Thyroid Function Tests / methods*
  • Thyroid Neoplasms / blood
  • Thyroid Neoplasms / diagnosis*
  • Thyroid Neoplasms / metabolism
  • Thyroid Nodule / blood
  • Thyroid Nodule / diagnosis

Substances

  • Biomarkers, Tumor
  • Calcitonin
  • Pentagastrin
  • Calcium

Supplementary concepts

  • Thyroid cancer, medullary