Early diagnosis and curative therapy of medullary thyroid carcinoma by routine measurement of serum calcitonin in patients with thyroid disorders
Early diagnosis and curative therapy of medullary thyroid carcinoma by routine measurement of serum calcitonin in patients with thyroid disorders
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DOI：
10.1089/thy.2005.15.1267
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发表时间：
2005-11-01
期刊：
影响因子：
6.6
通讯作者：
Baumgartner-Parzer, S
中科院分区：
文献类型：
--
作者：
Vierhapper, H;Niederle, B;Baumgartner-Parzer, S
为了确定甲状腺髓样癌(MTC)处于潜在可治愈阶段的患者，对14,000名转至甲状腺门诊的患者(包括10,158名甲状腺结节患者)的血清降钙素(HCT)浓度进行了测定。排除转诊时已知基础Hct升高的患者，507例甲状腺结节患者的基础Hct>10pg/ml，静脉注射五肽胃泌素(0.5mug/kgbw)刺激后，103例患者的Hct>100pg/ml。本组包括32例新发MTC(29例散发性MTC和3例新的家族性MTC)和43例C细胞增生症(CCH)。在3843例无甲状腺结节的患者中，2例有散发性MTC，4例有CCH。与本所开展HCT筛查前每1000例结节性甲状腺疾病患者中的1.1例MTC相比，在所有甲状腺结节患者中，每1000例患者中检测到的MTC为3.2例。所有甲状腺结节患者的Hct测定有助于及时诊断MTC，从而为根治性手术提供了机会。
To identify patients with medullary thyroid carcinoma (MTC) at a potentially curable stage of the disease, serum concentrations of calcitonin (hCT) were determined in 14,000 patients (including 10,158 patients with thyroid nodules) referred to a thyroid outpatient clinic. Excluding patients in whom elevated basal hCT concentrations had already been known at the time of their referral, 507 patients with thyroid nodules presented basal concentrations of hCT of more than 10 pg/ml. Following stimulation by IV pentagastrin (0.5 mu g/kg BW), hCT concentrations of more than 100 pg/ml were seen in 103 patients. This group included 32 new cases of MTC (29 patients with sporadic MTC and 3 new index cases of the familial form) and 43 patients with C cell hyperplasia (CCH). Among the 3,843 patients without thyroid nodules, 2 were found to harbor sporadic MTC while 4 had CCH. As compared to 1.1 cases of MTC per 1,000 patients with nodular thyroid diseases diagnosed in our institution before hCT screening was begun, 3.2 cases of MTC per 1,000 patients were identified when hCT was determined in all patients with thyroid nodules. The determination of hCT in all patients with thyroid nodular disease facilitates the timely diagnosis of MTC, thus providing the chance of curative surgery.