Useful and limits of the biochemical markers for the diagnosis of thyroid carcinoma

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Paolo Colombo
Fabiana Locatelli
Pietro Travaglini

Abstract

A series of biochemical parameters are useful for the diagnosis and follow-up of differentiated thyroid carcinomas.


The measurement of serum thyroglobulin (Tg) is considered for the post-surgical/radioiodine follow-up of papillary/follicular carcinomas. Other than in basal conditions, the importance of Tg levels during TSH stimulation is underlined, either by discontinuation of L-T4 therapy or by recombinant human TSH test. The finding of undetectable Tg levels during TSH stimulation is highly correlated with clinical remission; otherwise, peak Tg levels > 1-2 ng/ml can be suggestive of recurrence/persistence of the disease. The accuracy of Tg measurements for the detection of metastases seems to be higher when compared to 131-I whole-body scan.


The evaluation of basal serum calcitonin levels is recommended for the screening of medullary thyroid carcinoma (MTC). High basal levels suggest the presence of a tumor but a calcitonin increase can be observed also in parafollicular C cell hyperplasia (CCH) and other extra-thyroidal conditions. The pentagastrin test can by pass this obstacle as the calcitonin response seems to be typical of pathological thyroid C cells. The cut-off value of calcitonin response between patients with MTC and CCH remains to be established; the latter condition, however, being considered by some authors as pre-cancerous. After thyroid surgery the measurement of calcitonin constitutes a valid tool for the detection of cure and/or recurrence of the disease.


The screening by means of RET oncogene analysis is also described for patients with MTC with Multiple Endocrine Neoplasia (MEN) type 2 syndrome.

Article Details

How to Cite
Colombo, Paolo, et al. “Useful and Limits of the Biochemical Markers for the Diagnosis of Thyroid Carcinoma”. Annali Italiani Di Chirurgia, vol. 77, no. 3, May 2006, pp. 209-14, https://annaliitalianidichirurgia.it/index.php/aic/article/view/2557.
Section
Review