Calcitonin as a biomarker of C cell disease: recent achievements and current challenges
Abstract
The neoplastic proliferation of parafollicular thyroid cells (C cells) may occur as either medullary thyroid carcinoma (MTC) or C cell hyperplasia (CCH) and is generically defined C cell disease. Since Calcitonin (CT) expression is fully maintained in neoplastic C cells, this hormone represents a sensitive marker for neoplasia of C cell derivation such as CCH and MTC. Serum CT levels display a high prognostic value and accurate estimation of tumor burden, allowing early detection of persistence/relapse and representing a reliable marker of response to treatment. Indeed, elevated CT levels can occur in other non-C cell-related conditions (i.e., other malignancies, systemic diseases, and pharmacological treatments). Moreover, some de-differentiated, more aggressive MTCs may present disproportionately low-circulating CT levels, as compared with tumor burden. During the postsurgical follow-up of MTC patients, CT levels usually parallel tumor progression and their increase unambiguously announces persistence/relapse. In this respect, CT Doubling Time (DT) has been proposed as prognostic factor of potential use for the identification of more aggressive MTCs. The present review will summarize the novel achievements on the clinical suitability of CT as a biomarker in clinical oncology and will point the attention to the most recent results concerning the usefulness and the possible drawbacks of circulating CT as a surrogate marker for the identification of rapidly progressing MTC patients, such as those candidate to targeted therapies. The emerging role of circulating CT as a parameter of response to local and systemic therapies will also be illustrated.
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For adults, CT values <10 ng/L indicate no C cell disease.
“CT values <10 ng/L indicate no C cell diseases”
For adults, CT values >1,000 ng/L have a positive predictive value of 100% for MTC.
“For adults, values >1,000 ng/L of CT revealed a positive predictive value of 100% for MTC”
For adults, basal CT values >20 ng/L are positive predictive values in the diagnosis of MTC.
“values >20 ng/L for basal CT are positive predictive values in the diagnosis of MCT [38]”
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- Authors
- Costante, G., & Meringolo, D.
- Affiliations
- Université Libre de Bruxelles (BE)
- Istituto Ramazzini (IT)
- Corresponding author
- Costante, Giuseppe
- ORCID
- Costante, Giuseppe
- Venue
- Endocrine
- Published
- 2020-01-10
- Volume
- 67
- Issue
- 2
- Pages
- 273-280
- ISSN
- 0969-711X (ISSN-L)
- 1355-008X
- 1559-0100
- OpenAlex
- W2999147446
- Cited by
- 41
- References
- 59
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 2 · 2023: 7 · 2022: 8 · 2021: 8 · 2020: 3 · 2019: 1
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Keywords
- calcitonin, medullary thyroid carcinoma, C-cell hyperplasia, serum calcitonin, prognostic factors, tumor recurrence, treatment response monitoring, targeted therapy
- MeSH terms
- Calcitonin, Humans, Neoplasm Recurrence, Local, Thyroid Gland, Thyroid Neoplasms, Biomarkers, Tumor, Carcinoma, Medullary
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