Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2012, vol. 21, nr 2, March-April, p. 169–178

Publication type: original article

Language: English

Calcitonin and Procalcitonin in Patients with Medullary Thyroid Cancer or Bacterial Infection

Kalcytonina i prokalcytonina u pacjentów z rakiem rdzeniastym tarczycy lub infekcją bakteryjną

Krzysztof Kaczka1,, Sławomir Mikosiński2,, Wojciech Fendler3,, Agnieszka Celnik1,, Lech Pomorski1,

1 Department of General and Oncological Surgery, Medical University of Łódź, Poland

2 Department of Nuclear Medicine and Oncological Endocrinology, Maria Skłodowska-Curie Memorial Hospital, Zgierz, Poland

3 Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Łódź, Poland

Abstract

Objectives. To evaluate procalcitonin (PCT) utility as a marker of medullary thyroid cancer (MTC).
Material and Methods. Calcitonin (CT) and PCT levels were measured in MTC patients and patients with serious bacterial infections. 70 patients were enrolled in the study: 6 MTC active patients: 4 with disseminated, unreoperable disease and 2 re-operated patients, in whom markers were checked before and after surgery; 23 MTC patients in remission after radical surgery; 11 non-toxic nodular goiter (NTNG) patients; 30 patients with severe, bacterial infection or sepsis.
Results. All MTC active patients had greatly elevated CT and PCT levels. In two re-operated patients, marker levels decreased but were still above the reference range. In 15 MTC patients in remission, the levels of either marker were not increased. Both markers were slightly increased in 3 patients in this group, while CT was elevated in 5 patients. In all but 1 patient in the NTNG group, both marker levels were not elevated. Among patients with bacterial infection, PCT and CT levels showed no increase in 8 patients, both markers were elevated in 10 patients, and an increase of PCT levels was seen in 10 patients while of CT only in 2 patients. Correlations between CT and PCT values were very strong in MTC patients (r = 0.95; p = 0.004 for active MTC, r = 0.60; p = 0.002 for MTC patients in remission) and in patients with NTNG (r = 0.77; p = 0.02). In patients with infection, both parameters were completely independent (r = 0.002; p = 0.99).
Conclusion. PCT measurement could be an alternative to CT measurement for evaluation of MTC status.

Streszczenie

Cel pracy. Ocena przydatności prokalcytoniny jako markera raka rdzeniastego tarczycy.
Materiał i metody. Stężenia kalcytoniny i prokalcytoniny zmierzono u pacjentów z rakiem rdzeniastym tarczycy lub ciężką infekcją bakteryjną. Do badania włączono 70 pacjentów: 6 pacjentów z aktywną postacią raka rdzeniastego tarczycy: 4 z rozsianą, nieresekcyjną postacią nowotworu; u 2 pozostałych chorych stężenia markerów zmierzono przed i po operacji; 23 pacjentów z rakiem rdzeniastym tarczycy w remisji po radykalnym zabiegu operacyjnym; 11 pacjentów z wolem guzowatym obojętnym; 30 pacjentów z ciężką infekcją bakteryjną lub posocznicą.
Wyniki. Wszyscy pacjenci z aktywną postacią raka rdzeniastego tarczycy mieli znacznie zwiększone stężenia kalcytoniny i prokalcytoniny. U dwóch reoperowanych chorych stężenia obu markerów zmniejszyły się, ale wciąż pozostawały powyżej normy. U 15 pacjentów w remisji raka rdzeniastego tarczycy nie odnotowano zwiększenia stężenia żadnego z markerów. Stężenia obu markerów były nieznacznie zwiększone u 3 chorych z tej grupy. U 5 pacjentów odnotowano jedynie nieznacznie zwiększone stężenie kalcytoniny. U wszystkich oprócz jednego pacjenta z wolem guzowatym obojętnym stężenia obu markerów nie były zwiększone. Wśród pacjentów z infekcją bakteryjną nie zaobserwowano wzrostu stężenia prokalcytoniny i kalcytoniny u 8 pacjentów. Stężenia obu markerów były zwiększone u 10 chorych. Wzrost stężenia jedynie prokalcytoniny odnotowano u 10 chorych, podczas gdy wzrost stężenia kalcytoniny tylko u 2 pacjentów. Stwierdzono silną korelację stężeń kalcytoniny i prokalcytoniny u pacjentów z rakiem rdzeniastym tarczycy (r = 0,95; p = 0,004 dla aktywnej postaci raka rdzeniastego tarczycy, r = 0,60; p = 0,002 dla pacjentów z rakiem rdzeniastym tarczycy w stadium remisji). U pacjentów z ciężką infekcją oba wskaźniki były całkowicie niezależne (r = 0,002; p = 0,99).
Wnioski. Prokalcytonina może być alternatywnym w stosunku do kalcytoniny markerem w ocenie stopnia zaawansowania raka rdzeniastego tarczycy.

Key words

procalcitonin, calcitonin, medullary thyroid cancer

Słowa kluczowe

prokalcytonina, kalcytonina, rak rdzeniasty tarczycy

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