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Calcitonin Thresholds for Prediction of Medullary Thyroid Carcinoma and its Clinical Response in MEN2A Gene Carriers - PubMed

6 days ago
  • #Medullary Thyroid Carcinoma
  • #Calcitonin
  • #MEN2A
  • The study evaluates calcitonin (CTN) thresholds for predicting medullary thyroid carcinoma (MTC) and clinical response in MEN2A gene carriers.
  • Retrospective analysis of 106 gene carriers from an Italian tertiary referral center (1993-2024) was conducted.
  • Most common mutation was RET V804M (34.3%), followed by mutations at codon 634 (16.2%).
  • 81.1% of patients had MTC, while 18.9% had C-cell hyperplasia (CCH) alone.
  • MTC patients were older, with higher preoperative basal (bCTN) and stimulated (sCTN) calcitonin levels.
  • bCTN > 12.60 ng/L identified MTC with 94.4% sensitivity and 74.3% specificity.
  • Incomplete response (IR) was observed in 22.9% of patients over a median follow-up of 6.8 years.
  • bCTN < 28.25 ng/L predicted excellent response (ER) with 95.5% specificity and 76.8% sensitivity.
  • Multivariate analysis identified bCTN < 28.25 ng/L and absence of lymph node metastases as independent predictors of ER.
  • Gene carriers with preoperative bCTN between 12.6 and 28.3 ng/L have high probability of complete remission post-surgery.