Combining serum calcitonin, carcinoembryonic antigen, and neuron-specific enolase to predict lateral lymph node metastasis in medullary thyroid carcinoma

J Clin Lab Anal. 2020 Jul;34(7):e23278. doi: 10.1002/jcla.23278. Epub 2020 Mar 6.

Abstract

Background: This study aimed to investigate the clinical application of combined detection of serum calcitonin (Ctn), carcinoembryonic antigen (CEA), and neuron-specific enolase (NSE) in predicting lateral lymph node metastasis (LLNM) in medullary thyroid carcinoma (MTC).

Methods: Seventy-four consecutive patients with MTC were enrolled. The relationship between serum Ctn, CEA, and NSE and LLNM was retrospectively analyzed by univariate analysis and logistic regression analysis. Furthermore, the clinical application of serum Ctn, CEA, and NSE combined detection in prediction of LLNM in MTC was also evaluated.

Results: The rate of LLNM in this study was 48.64% (36/74).The expression levels of serum Ctn, CEA, and NSE in MTC with LLNM were significantly higher than those without LLNM (all P < .01). The area under the curve (AUC) predicted by serum Ctn, CEA, and NSE for LLNM in MTC patients was 0.867, 0.831, and 0.726, respectively, and the AUC of serum Ctn, CEA, and NSE combined detection was up to 0.890, higher than using a single biomarker. The sensitivity and specificity of serum Ctn, CEA, and NSE combined detection in prediction of LLNM were 88.89% and 81.57%, respectively.

Conclusions: The concentrations of serum Ctn, CEA, and NSE are closely related to LLNM in MTC, and the combined detection of all three biomarkers has a higher clinical value in the evaluation of MTC patients with LLNM. With more perspective study in the future, it would be an indicator of influencing personalized surgical strategy for different MTC patients.

Keywords: calcitonin; carcinoembryonic antigen; lymph node metastasis; medullary thyroid carcinoma; neuron-specific enolase.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / blood
  • Calcitonin / blood*
  • Carcinoembryonic Antigen / blood*
  • Carcinoma, Neuroendocrine / blood
  • Carcinoma, Neuroendocrine / pathology*
  • Carcinoma, Neuroendocrine / surgery
  • Female
  • Humans
  • Lymph Node Excision
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis / pathology*
  • Male
  • Middle Aged
  • Phosphopyruvate Hydratase / blood*
  • Thyroid Neoplasms / blood
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / surgery

Substances

  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Calcitonin
  • ENO2 protein, human
  • Phosphopyruvate Hydratase

Supplementary concepts

  • Thyroid cancer, medullary