Gender and tumor size-specific calcitonin cutoff value for diagnosing MTC in 10,618 patients with thyroid nodule surgery.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2024-07-22 DOI:10.1007/s12020-024-03969-z

Jiajia Ni, Pinghui Tu, Yan Ling

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Abstract

Background: Calcitonin is a sensitive marker for medullary thyroid carcinoma (MTC) diagnosis and postsurgical follow-up. This study aimed to define the gender and tumor size-specific calcitonin cutoff values for diagnosing MTC.

Methods: This retrospective study recruited 95 MTC patients and 10,523 non-MTC patients who underwent thyroid nodule surgery at Zhongshan Hospital between January 2015 and June 2023. Receiver operating characteristic (ROC) curves were used to assess calcitonin cutoff values for diagnosing MTC.

Results: Calcitonin levels in non-MTC patients were influenced by gender, CKD stage and age, with gender being the highest ranked predictor. In MTC patients, calcitonin levels were associated with tumor diameter, lymph node metastasis, and TNM stage. In the entire study population, calcitonin cutoff values to diagnose MTC were 17.75 pg/mL for males (sensitivity: 97.60%, specificity: 99.40%) and 7.15 pg/mL for females (sensitivity: 94.34%, specificity: 99.22%). In patients with a thyroid nodule diameter ≤10 mm, the calcitonin cutoff values to diagnose MTC were 17.50 pg/mL for males (sensitivity: 95.00%, specificity: 99.27%) and 7.15 pg/mL for females (sensitivity: 90.91%, specificity: 99.04%). In patients with a thyroid nodule diameter >10 mm, the calcitonin cutoff values to diagnose MTC were 104.80 pg/mL for males (sensitivity: 100.00%, specificity: 100.00%) and 32.60 pg/mL for females (sensitivity: 96.77%, specificity: 100.00%).

Conclusion: We have identified the gender and tumor size-specific cutoff values for the diagnosis of MTC. Cutoff values based on gender and tumor diameter may help to improve the accuracy of preoperative diagnosis of MTC, which is worth to be verified by future studies.

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在 10,618 名接受甲状腺结节手术的患者中，诊断 MTC 的性别和肿瘤大小特异性降钙素原临界值。

背景：降钙素是甲状腺髓样癌（MTC）诊断和手术后随访的敏感指标。本研究旨在确定诊断 MTC 的性别和肿瘤大小特异性降钙素原临界值：这项回顾性研究招募了2015年1月至2023年6月期间在中山医院接受甲状腺结节手术的95例MTC患者和10523例非MTC患者。采用接收者操作特征曲线（ROC）评估诊断 MTC 的降钙素切点值：非 MTC 患者的降钙素水平受性别、CKD 分期和年龄的影响，其中性别是排名最高的预测因素。在 MTC 患者中，降钙素水平与肿瘤直径、淋巴结转移和 TNM 分期有关。在所有研究人群中，男性诊断 MTC 的降钙素原临界值为 17.75 pg/mL（灵敏度：97.60%，特异性：99.40%），女性为 7.15 pg/mL（灵敏度：94.34%，特异性：99.22%）。在甲状腺结节直径≤10 毫米的患者中，男性降钙素诊断 MTC 的临界值为 17.50 pg/mL（灵敏度：95.00%，特异性：99.27%），女性为 7.15 pg/mL（灵敏度：90.91%，特异性：99.04%）。在甲状腺结节直径大于 10 毫米的患者中，男性降钙素诊断 MTC 的临界值为 104.80 pg/mL（敏感性：100.00%，特异性：100.00%），女性为 32.60 pg/mL（敏感性：96.77%，特异性：100.00%）：我们确定了诊断 MTC 的性别和肿瘤大小特异性临界值。基于性别和肿瘤直径的临界值可能有助于提高 MTC 术前诊断的准确性，这值得今后的研究加以验证。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.